**4. Eligibility criteria**

The study included all patients undergoing coronary artery bypass grafting, who underwent surgery in an Emergency Institute for Cardiovascular Diseases between January 1st 2008 and May 1st 2011 who did not have the non – eligibility criterias.

Patients were over the age of 21, and able to provide informed consent and agreed to comply with all protocol-specified procedures.

**6. Study drop out criteria**

ternal bleeding)

informed consent form.

the end of the study period.

and colonoscopy.

The occurrence of adverse events (skin reactions, gastrointestinal symptoms, active in‐

The Antiagregant Treatment After Coronary Artery Surgery Depending on Cost – Benefit Report

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The protocol was approved by the institute management, and every patient signed the

The essential inclusion criteria (gender,mean age, comorbidities, number of grafts per patient, the type of the grafts (arterial or venous) and the mean left ventricular ejection fraction, left ventricular diastolic performance and left atrial dimensions (diameters and area), the duration of treatment and assessment criteria were similar in the three treatment groups (p<0.0001). All patients received standard therapy including beta blockers, IEC, statins throughout the study period. The patients with exclusive arterial revascularisation also received calcium channel

Clinical and laboratory parameters were initially assessed, at baseline and at each visit until

The clinical measurements included: NYHA class for heart failure, presence of angina pectoris,

Laboratory parameters included: the usual blood tests (platelet count, hemoglobin, hematocrit, aminotransferases, LDH, biochemistry cholesterol and tryglycerides levels), electrocardio‐ gram(with the evaluation of rhythm, frequence and ST-T elevation), 24 hours ECG Holter monitoring for silent ischemia, stress efort test at 1,3,6 months and 1 year postoperatively and when angina occurred (Bruce or Bruce modified protocol), echocardiography (with assessment of the LV dimensions, ventricular sistolic and diastolic performance, ventricular walls contractility - segmental kinetics, mitral regurgitation degree) and coronarography at 1 year when the other tests where positive for ischemia. Also, at each visit were recorded the occurrence of major and minor bleeding episodes, gastrointestinal symptoms, skin reactions,

24 hours ECG Holter used a 12 channels monitoring with the evaluation of conduction or

Treadmill stress test was done at 1, 3, 6 months and at 1 year postoperatively and used Bruce or Bruce modified protocol. If the stress test or Holter monitoring diagnosed ischemia at one

Early development of graft occlusion was diagnosed based on clinical criteria and through electrocardiogram, Holter monitoring, thoracic and transesophageal echocardiography. The appearance of gastrointestinal bleeding was diagnosed using clinical evaluation, endoscopy

Failure to comply with the hospital protocol/ absence to follow-up

blockers agents but their number was similar in the three groups of study.

ventricular rhytm, patient compliance and quality of life.

thrombocytopenia and lab tests abnormalities.

rhythm disturbances or occurrence of silent ischemia.

follow up visit, this was the indication for performing coronarography.

**Figure 1.** Treatment protocol phases
