{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:42:40Z","timestamp":1792291360795,"version":"4.4.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p\/><jats:sec><jats:title>OBJECTIVES<\/jats:title><jats:p>Data on the safety and efficacy of clopidogrel (CPD) monotherapy after coronary artery bypass grafting (CABG) are limited. We compared the clinical outcomes and graft patency rates during 4 years in CABG patients who maintained CPD or aspirin after 1 year of dual antiplatelet therapy (DAPT) use.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A total of 671 patients who maintained 1-year DAPT after CABG with all grafts patent on one-year follow-up angiography and switched to single antiplatelet therapy (SAPT) using CPD (n\u2009=\u2009272) or aspirin (n\u2009=\u2009399) between January 2009 and December 2015 were enrolled. Propensity score matching analysis was used, and 227 pairs were matched in a 1:1 ratio. Overall mortality, cardiac mortality, and major adverse events, including all-cause mortality, acute myocardial infarction, coronary reintervention or reoperation, ischaemic stroke, and major bleeding, were compared. Graft patency was evaluated using graft angiography 5 years post-surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Overall survival and the incidence of major adverse events during the 4-year follow-up did not differ significantly between the groups when un-matched (hazard ratio [HR], 95% confidence interval [CI]=1.24, 0.71 to 2.15, P\u2009=\u20090.46 and HR, 95% CI\u2009=\u20091.22, 0.77 to 1.92, P\u2009=\u20090.41, respectively) or matched (HR, 95% CI\u2009=\u20091.05, 0.55 to 2.01, P\u2009=\u20090.89 and HR, 95% CI\u2009=\u20091.01, 0.60 to 1.73, P\u2009=\u20090.96, respectively). In the postoperative 5-year graft angiography, new graft occlusion was found in 3.2% and 4.7% of patients and newly occurred graft occlusion rates of distal anastomoses were 1.2% and 1.6% in the CPD and aspirin groups, respectively, and were not statistically different between the 2 groups (P\u2009=\u20090.39 and 0.63, respectively). Changes of antiplatelet regimen were needed in 22.8% (91 of 399) of aspirin group and in 2.2% (6 of 272) of CPD group from the initiation of SAPT (P\u2009&amp;lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>In this series of patients undergoing CABG who received DAPT and remained stable for 1\u2009year, SAPT maintenance with CPD or aspirin did not show any significant differences in 4-year outcomes such as all-cause mortality, major adverse events, and newly occurring graft occlusion. However, more patients taking aspirin required changes in antiplatelet regimens to other antiplatelet or anticoagulation therapies.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ejcts\/ezad128","type":"journal-article","created":{"date-parts":[[2023,4,11]],"date-time":"2023-04-11T15:14:02Z","timestamp":1681226042000},"source":"Crossref","is-referenced-by-count":7,"title":["Comparative effectiveness of clopidogrel versus aspirin as a maintenance monotherapy 1 year after coronary artery bypass grafting"],"prefix":"10.1093","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2908-7130","authenticated-orcid":false,"given":"Ji Seong","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine , Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2528-173X","authenticated-orcid":false,"given":"Yoonjin","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine , Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7391-3415","authenticated-orcid":false,"given":"Suk Ho","family":"Sohn","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine , Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8935-8118","authenticated-orcid":false,"given":"Ho Young","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine , Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,4,11]]},"reference":[{"key":"2023041319304020900_","doi-asserted-by":"crossref","first-page":"2751","DOI":"10.1161\/01.CIR.96.8.2751","article-title":"Aspirin as a therapeutic agent in cardiovascular disease - A statement for healthcare professionals from the American Heart Association","volume":"96","author":"Hennekens","year":"1997","journal-title":"Circulation"},{"key":"2023041319304020900_","first-page":"e4","article-title":"2021 ACC\/AHA\/SCAI Guideline for Coronary Artery Revascularization: executive Summary: a Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice 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