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Ann Thorac Surg 1987;43:318-322
© 1987 The Society of Thoracic Surgeons
From the Departments of Surgery (Division of Cardiovascular Surgery) and Medicine (Division of Hematology/Oncology), New York Hospital—Cornell Medical Center, New York, NY
Accepted for publication May 28, 1986.
* Address reprint requests to Dr. Karwande, Department of Surgery, VA Medical Center, 500 Foothill Blvd, Salt Lake City, UT 84148
Patients undergoing aoitocoronary bypass using autogenous saphenous veins were randomly divided into three comparable groups. Group 1 (n = 10) acted as a control, Group 2 (n = 14) received 80 mg of aspirin at midnight before the operation, and Group 3 (n = 12) received 80 mg of aspirin and 75 mg of dipyridamole at midnight and an additional 75-mg dose of dipyridamole at 6 AM. The purpose was to determine which regimen would maximally inhibit platelet function without depressing vascular prostacyclin synthesis. Serum thromboxane A2, saphenous vein wall and aortic wall prostacyclin, platelet aggregation, and bleeding time were measured in all patients. None was restarted on a regimen of aspirin or dipyridamole postoperatively.
Aspirin alone and in combination with dipyridamole significantly inhibited thromboxane A2 and platelet aggregation in all treated patients but spared venous prostacyclin synthesis. Aortic prostacyclin synthesis was partially inhibited in both treated groups. Chest tube drainage was comparable in all three groups. These results indicate that the combination of aspirin and dipyridamole offers no measurable advantage over aspirin alone in the perioperative period.
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