CASPAR: Dual antiplatelet therapy benefits analysed

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Results from the Clopidogrel (Plavix) and aspirin in Bypass Surgery for Peripheral Arterial disease (CASPAR) were presented at VEITHsymposium. The randomised trial evaluated whether clopidogrel 75mg/day vs. placebo leads to an increased rate of primary patency, limb salvage and survival in patients receiving a below-the-knee bypass graft. Of the 851 patients enrolled, 30% had received a prosthetic graft and 70% a venous graft.
The investigators found no difference in the primary composite endpoint with dual antiplatelet therapy. Based on prespecified subgroup analysis by type of graft, they observed a significant benefit in outcome of grafting with dual antiplatelet therapy in prosthetic grafts, and no benefit in outcome of grafting from dual antiplatelet therapy in venous grafts. Also, dual therapy resulted in more bleeding than monotherapy (2.1% vs. 1.2% severe bleeding).

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