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Benefits and risks of using clopidogrel before coronary artery bypass surgery: Systematic review and meta-analysis of randomized trials and observational.

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Presentation on theme: "Benefits and risks of using clopidogrel before coronary artery bypass surgery: Systematic review and meta-analysis of randomized trials and observational."— Presentation transcript:

1 Benefits and risks of using clopidogrel before coronary artery bypass surgery: Systematic review and meta-analysis of randomized trials and observational studies  Fausto Biancari, MD, PhD, K. E. Juhani Airaksinen, MD, PhD, Gregory Y.H. Lip, MD, PhD  The Journal of Thoracic and Cardiovascular Surgery  Volume 143, Issue 3, Pages e4 (March 2012) DOI: /j.jtcvs Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Literature search and study selection of randomized controlled trials. RCT, Randomized controlled trial. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Risk of 30-day postoperative composite cardiovascular event (cardiovascular death, myocardial infarction, or stroke) in patients who received clopidogrel versus placebo before CABG. Only data from post hoc analysis of prospective randomized trials are included in this analysis. CLARITY, Clopidogren as Adjunctive Reperfusion Therapy; CREDO, Clopidogrel for the Reduction of Events During Observation; CURE, Clopidogrel in Unstable Angina to Prevent Recurrent Ischemic Events; CI, confidence interval. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Literature search and study selection of observational studies. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

5 Figure 4 Pooled RR of immediate postoperative death in patients who received clopidogrel before CABG versus controls (observational cohort studies only included). CI, Confidence interval. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

6 Figure 5 Pooled RR of reoperation for bleeding in patients who received clopidogrel before CABG versus controls (observational cohort studies only included). CI, Confidence interval. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

7 Figure 6 Weighted mean difference of drainage blood losses at 24 hours in patients who received clopidogrel before CABG versus controls (observational cohort studies only included). CI, Confidence interval. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

8 Figure 7 Pooled RR of postoperative packed red blood cells transfusion in patients who received clopidogrel before CABG versus controls (observational cohort studies only included). CI, Confidence interval. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

9 Figure 8 Pooled RR of immediate postoperative myocardial infarction in patients who received clopidogrel before CABG versus controls (observational cohort studies only included). CI, Confidence interval. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

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