In Reply Drs Shah and Hesterberg raised concerns about the optimal aspirin dosage for the prevention of saphenous vein graft failure after CABG. The 2011 ACC/AHA guideline recommended 100 to 325 mg/d of aspirin after CABG to reduce vein graft failure and major adverse cardiac event (MACE) rates.1 The 2015 AHA scientific statement for secondary prevention after CABG also recommended 81 to 325 mg/d of aspirin and stated that it was reasonable to consider mono-antiplatelet therapy with high-dosage aspirin (325 mg/d) to prevent aspirin resistance, although the benefits were not well evaluated.2 On the other hand, the 2014 European guidelines strongly support the use of low-dosage aspirin (75-100 mg/d) after CABG.3
Zhu Y, Zhao Q. Antiplatelet Therapy After Coronary Artery Bypass Grafting—Reply. JAMA. 2018;320(10):1036–1037. doi:10.1001/jama.2018.10446
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