Significance of Antibodies to Heparin/Platelet Factor 4 Complex in Vein Graft Patency and Potential Role of Argatroban for Prevention of Vein Graft Occlusion

Exclusion Criteria

• •1. Patients who, in the investigator's or attending surgeon's opinion, are unsuitable for anticoagulation due to their clinical status
• •2. Documented history of allergy to iodinated contrast media, warfarin, or argatroban
• •3. Chronic renal impairment with CrCl\<60 ml/min
• •4. Recent bleeding episode
• •5. Congestive Heart Failure (EF\< 30%)
• •6. Bleeding diathesis or known thrombophilic disorder
• •7. Atrial fibrillation or other condition requiring anticoagulation at the time of enrollment
• •8. Documented history of heparin induced thrombocytopenia
• •9. Clinical suspicion of HIT at the time of randomization, defined as 50% decrease in Platelet count from last heparin exposure or Platelet count \<100,000/ml
• •10. Hepatic dysfunction (defined as LFTs \> 3 times the upper limit of normal)
• •11. Patients with a history of bleeding complications post-CABG
• •12. Hemorrhagic stroke
• •13. Gastrointestinal bleeding
• •14. Requirement for fresh frozen plasma
• •15. Recent central nervous system or ophthalmic surgery
• •16. Aneurysm
• •17. History of psychosis or senility
• •18. Malignant hypertension
• •19. Clinically significant pericarditis or pericardial effusion
• •20. Bacterial endocarditis
• •21. Hematocrit \< 24%
• •22. Valve replacement or repair at time of CABG
• •23. Subjects with signs or symptoms of possible Transient Ischemic Attack or stroke