Two subsequent stud- ies suggested some benefit associated with warfarin treatment, but aspirin treatment had yet to be incorporated into everyday practice at that time.12,67 In the largest trial in the field, the Post-Coronary Artery Bypass Graft (Post-CABG) trial ran- domized 1351 patients to low-dose warfarin anticoagulation (mean international normalized ratio, 1.4) or placebo, with all patients receiving aspirin 81 mg daily. The authors noted no significant differences in angiographic outcome between the patients who were randomized to warfarin or placebo, and warfarin did not slow the process of vein graft disease.68 With inconsistent results reported from clinical trials and increased bleeding risks associated with warfarin, Fremes et summarized the literature with a meta-analysis of 17 tri- als on antithrombotic and antiplatelet therapy after CABG. This analysis illustrated that both aspirin (OR, 0.60; 95% CI, 0.33 0.93; P=0.025) reduced the odds of graft occlusion com- pared with placebo. However, anticoagulation did not improve graft patency compared with aspirin alone (OR, 0.95; 95% CI, 0.62 1.44; P=0.87). Overall, the data do not support the use of warfarin anti- thrombotic therapy to prevent graft occlusion after CABG or to slow the process of vein graft disease. Outside the scope of this statement and covered in detail elsewhere, postopera- tive antithrombotic therapy should continue to be reserved for patients recovering from CABG who have other indications for warfarin, including those with atrial fibrillation (AF),69 patients with a history of venous thromboembolism,70 and those who undergo concurrent valve replacement at the time When warfarin is prescribed after CABG, aspirin is typically administered at lower doses (75 162 mg daily) to reduce the risk of bleeding complications.69 71 Although newer antithrombotic agents (dabigatran, apixaban, rivaroxaban) have recently become available, their efficacy in the CABG population has yet to be prospectively evaluated. 