Longtermclinical outcome ofcoronary surgery and assessmentofthebenefit obtained withpostoperative aspirin anddipyridamole

hadbeen adopted. During thefollow up period there were 25deaths ofwhich17were duetocardiac causes (average annual cardiac mortality 0-8%).Of280patients available forcontact,250(89-3%) attended anoutpatient interview. Ninety four(37-6%) patients complained ofrecurrentangina but inonly23(9-2%) was this severe.Twohundred andeleven (84-4%) ofthe250patients underwent exercise stresstesting. There were 73(34-6%) abnormal testsofwhich52were inthegroup of94 patients withrecurrentangina. Myocardial infarction occurred innineofthe250patients during thefollow up period. Twentysixpatients (10-4%) hadreinvestigation forsymptoms.Thisgroup hada graft occlusion rateof52%.Halfthese patients haverequired reoperation and20of22 occluded orseverely stenosed grafts werereplaced. Inonly twoinstances were veingrafts inserted into vessels with new disease. Halfoftheoriginal group were given aspirin (330 mg three times a day) plusdipyridamole (75mg three times aday). Ofthe250patients interviewed, 122tookaspirin anddipyridamole fromthesecond postoperative dayfor a mean of25months, withwarfarin for three months. Theother 128patients tookplacebo for amean of23monthstogether withwarfarin forthree months. Thislong termtreatmentwithaspirin plusdipyridamole conferred no significant benefit forallclinical outcomesmeasured atamean of6-6years.