Reply to Colli and Mestres. Controversial issues regarding aspirin and clopidogrel therapy for patients after cardiac surgery

In the July issue of the EJCTS, Dunning and co-workers published the EACTS guidelines on antiplatelet and anticoagulation management in cardiac surgery [1]. We have read with great interest these guidelines and we would like to underline a few points that we understand need further clarification. pcom 1. T /ejcts/a-abstract/35/ he ACC/AHA guidelines 2006 recommend the addition of aspirin 75—100 mg once daily to therapeutic warfarin for all patients with mechanical heart valves and those patients with biological valves who have risk factors (Level of Class I, Evidence: B) [2]. The ACCP 2008 guidelines recommend the addition of ASA only in patients with mechanical valves and additional factors for thromboembolism (AF, hypercoagulable state or low ejection fraction) (grade 1B). /1 2. T