This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Revascularization  • Surgical Interventions  • Cardiovascular/ Cardiothoracic Surgery  • Genetic Counseling/ Testing/ Therapy  • Cardiovascular Intervention  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In Reply: Dr Parolari and colleagues propose that early VGF may result from coagulation perturbations following cardiopulmonary bypass or cardiac surgery itself. Early VGF has largely been attributed to technical and flow-related factors; however, the systemic and perhaps local perturbations of platelet hemostasis and coagulation that occur with cardiac surgery also may be important.¹ Despite limited randomized clinical trial data supporting efficacy (or safety), dual antiplatelet therapy was used postoperatively in almost 20% of the PREVENT IV participants and was associated with a modestly higher unadjusted rate of VGF than aspirin alone (51% vs 42%; ² P = .002). We support the need for additional research and adequately powered clinical trials on safer, more effective antithrombotic regimens before, during, and after CABG surgery to improve graft patency and more importantly to reduce ischemic and hemorrhagic clinical events.

Mr Lau and Dr Kritharides speculate that edifoligide may affect neointimal proliferation despite neutral angiographic . . . [Full Text of this Article]

John H. Alexander, MD, MS
alexa017@mc.duke.edu

Robert A. Harrington, MD
Duke University Medical Center
Durham, NC

T. Bruce Ferguson, MD
Louisiana State University
New Orleans

Eric D. Peterson, MD, MPH
Duke University Medical Center
Durham, NC

C. Michael Gibson, MD
PERFUSE Angiographic Core Laboratory
Boston, Mass

Nicholas T. Kouchoukos, MD
Missouri Baptist Medical Center
St Louis

for the PREVENT IV Investigators

RELATED ARTICLES

Efficacy and Safety of Edifoligide, an E2F Transcription Factor Decoy, for Prevention of Vein Graft Failure Following Coronary Artery Bypass Graft Surgery: PREVENT IV: A Randomized Controlled Trial

JAMA. ;294():2446-2454.
FULL TEXT  

Efficacy and Safety of Edifoligide
, , , and
JAMA. ;295():1513-1513.
FULL TEXT  

Efficacy and Safety of Edifoligide
and
JAMA. ;295():1513-1514.
FULL TEXT  

Efficacy and Safety of Edifoligide
and
JAMA. ;295():1514-1514.
FULL TEXT