Platelet-suppressant therapy in patients with coronary artery disease

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Abstract
Platelets may contribute to the pathogenesis of atherosclerosis and to the complications of coronary atherosclerosis, acute myocardial infarction, unstable angina and sudden cardiac death. Platelets may contribute to saphenous vein aortocoronary graft occlusion. Of 104 men with coronary artery disease, platelet survival (SURV) (51Cr-labeling) was shortened in 68% (3.1 .+-. 0.03 days [average .+-. SEM[standard error of the mean]]; normal, 3.7 .+-. 0.03 days; P < .001). Platelet-suppressant drugs (sulfinpyrazone, clofibrate and dipyridamole) increased SURV. Saphenous vein graft occlusion was associated with shortened SURV. Of 36 men with occlusion of at least 1 graft, SURV was shortened in 35 (2.5 .+-. 0.08 days), but in 19 with all grafts open, SURV was shortened in 6 (3.5 .+-. 0.10 days; P < .001). These drugs increased SURV (2.3 .+-. 0.08 to 2.7 .+-. 0.11 days; P < .01) and were associated with improved graft patency (4 of 32 grafts are initial bypass vs. 30 of 34 grafts open after 2nd operation).