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Clopidogrel Treatment and the MEND-CABG II Trial
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To the Editor: The MEND-CABG (MC-1 to Eliminate Necrosis and Damage in Coronary Artery Bypass Graft Surgery Trial) II investigators1 have shown that pyridoxal 5"-phosphate monohydrate (MC-1) did not reduce cardiovascular death or nonfatal myocardial infarction (MI) in intermediate- to high-risk patients undergoing coronary artery bypass graft (CABG) surgery. According to their data, there were no significant differences in concomitant medical therapies during hospitalization between the MC-1 and placebo groups (Table 4).
Clopidogrel, an adenosine diphosphate receptor antagonist, is another important, widely used antiplatelet drug for reducing ischemic events in patients with acute coronary syndrome.2 The benefit of clopidogrel use before or after CABG is controversial. Kapetanakis et al3 reported that clopidogrel administration increased the risk for hemostatic reoperation and the requirements for blood product transfusions during and after off-pump CABG. But McLean et al4 showed that early clopidogrel treatment among MI patients undergoing CABG was not associated with an . . . [Full Text of this Article]
Jaewon Oh, MD;
Namki Hong;
Seok-Min Kang, MD, PhD
smkang@yuhs.ac
Yonsei University College of Medicine
Seoul, Korea
RELATED ARTICLE
Efficacy and Safety of Pyridoxal 5'-Phosphate (MC-1) in High-Risk Patients Undergoing Coronary Artery Bypass Graft Surgery: The MEND-CABG II Randomized Clinical Trial
MEND-CABG II Investigators*
JAMA. 2008;299(15):1777-1787.
ABSTRACT
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RELATED LETTER
Clopidogrel Treatment and the MEND-CABG II Trial—Reply
John H. Alexander, Stephen J. Ellis, and Jean-Claude Tardif
JAMA. 2008;300(9):1021-1022.
EXTRACT
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