Evidence map›Paper›PMID 27556308›Full record

ArticleBrazilian journal of cardiovascular surgery2016

Clopidogrel use After Myocardial Revascularization: Prevalence, Predictors, and One-Year Survival Rate.

Paulo Roberto L Prates, Judson B Williams, Rajendra H Mehta, Susanna R Stevens, Laine Thomas, Peter K Smith, L Kristin Newby, Renato A K Kalil, John H Alexander, Renato D Lopes

Open access · diamondAbstract read
In one paragraph

Article in Brazilian journal of cardiovascular surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.7field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 3 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 2 countries.

Paulo Roberto L PratesInstituto de Cardiologia-Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
Judson B WilliamsDepartment of Surgery, Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, NC, United States.
Rajendra H MehtaDepartment of Medicine, Division of Cardiology, Duke University Medical Center, Durham, NC, United States.
Susanna R StevensDuke Clinical Research Institute, Durham, NC, United States.
Laine ThomasDuke Clinical Research Institute, Durham, NC, United States.
Peter K SmithDepartment of Surgery, Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, NC, United States.
L Kristin NewbyDepartment of Medicine, Division of Cardiology, Duke University Medical Center, Durham, NC, United States.
Renato A K KalilInstituto de Cardiologia-Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil.
John H AlexanderDepartment of Medicine, Division of Cardiology, Duke University Medical Center, Durham, NC, United States.
Renato D LopesDepartment of Medicine, Division of Cardiology, Duke University Medical Center, Durham, NC, United States.
Clinical Research Institute · USDuke Medical Center · USFundação Universitária de Cardiologia · BR

Funding

Cardiothoracic Surgical Network Clinical CenterU01HL088953 · NHLBI · DUKE UNIVERSITY · PI SMITH, PETER K · 2007 to 2013
$2.6M
Core Clinical Centers for the CTSNUM1HL088953 · NHLBI · DUKE UNIVERSITY · PI SMITH, PETER K · 2013 to 2017
$2.5M
NHLBI NIH HHS U01 HL088953NHLBI NIH HHS UM1 HL088953
6 · The paper itself

Abstract

introductionAntiplatelet therapy after coronary artery bypass graft (CABG) has been used. Little is known about the predictors and efficacy of clopidogrel in this scenario.

objectiveIdentify predictors of clopidogrel following CABG.

methodsWe evaluated 5404 patients who underwent CABG between 2000 and 2009 at Duke University Medical Center. We excluded patients undergoing concomitant valve surgery, those who had postoperative bleeding or death before discharge. Postoperative clopidogrel was left to the discretion of the attending physician. Adjusted risk for 1-year mortality was compared between patients receiving and not receiving clopidogrel during hospitalization after undergoing CABG.

resultsAt hospital discharge, 931 (17.2%) patients were receiving clopidogrel. Comparing patients not receiving clopidogrel at discharge, users had more comorbidities, including hyperlipidemia, hypertension, heart failure, peripheral arterial disease and cerebrovascular disease. Patients who received aspirin during hospitalization were less likely to receive clopidogrel at discharge (P≤0.0001). Clopidogrel was associated with similar 1-year mortality compared with those who did not use clopidogrel (4.4% vs. 4.5%, P=0.72). There was, however, an interaction between the use of cardiopulmonary bypass and clopidogrel, with lower 1-year mortality in patients undergoing off-pump CABG who received clopidogrel, but not those undergoing conventional CABG (2.6% vs 5.6%, P Interaction = 0.032).

conclusionClopidogrel was used in nearly one-fifth of patients after CABG. Its use was not associated with lower mortality after 1 year in general, but lower mortality rate in those undergoing off-pump CABG. Randomized clinical trials are needed to determine the benefit of routine use of clopidogrel in CABG.

Indexed as

AspirinCardiopulmonary BypassClopidogrelCoronary Artery BypassDrug Therapy, CombinationFemaleHumansMaleMiddle AgedMyocardial RevascularizationNorth CarolinaPatient DischargePlatelet Aggregation InhibitorsPostoperative CarePostoperative ComplicationsPostoperative PeriodAspirinClopidogrelPlatelet Aggregation InhibitorsTiclopidine

Identifiers

PMID27556308
PMCPMC5062735
OpenAlexW2316045702

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.