Antiplatelet and Anticoagulant Therapy after Coronary Bypass

To the Editor: The paper by Pantely et al. demonstrated that when antiplatelet therapy was instituted three days after coronary-artery bypass, there was no improvement in graft patency.¹ Platelet adhesion and release of platelet products into the vessel wall are presumably related to vascular myointimal proliferation and release of a platelet-derived mitogen that stimulates smooth-muscle cells to proliferate.² Experimental studies have confirmed this hypothesis by showing that myointimal proliferation after endothelial injury can be prevented by rendering animals thrombocytopenic before the injury.³ However, platelet granules are released almost immediately after endothelial injury, as shown in several studies of platelet turnover. . No extract is available for articles shorter than 400 words.