The unknown effect of clopidogrel resistance in dual antiplatelet therapies after coronary artery bypass grafting.

摘要

We read with great interest the article of Sorensen et al. (1) that reported the efficacy of post-operative clopidogrel treatment in a large patient cohort revascularized with coronary artery bypass graft surgery (CABG) after myocardial infarction. Notwithstanding the criterion of preoperative myocardial infarction, it remains interesting that this result is contrary to the CASCADE (Clopidogrel After Surgery for Coronary Artery DiseasE) trial, where addition of clopidogrel to aspirin revealed no changes on the post-operative outcomes (survival, 1-year intimal hyperplasia) (2). A possible explanation could be the different rates of aspirin and/or clopidogrel resistance between the 2 populations.