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Effect of aspirin on postoperative bleeding in coronary artery bypass grafting
Muhammad Kamran1, Ali Ahmed, Mudassir Iqbal Dar
1Department of Cardiac Surgery, Dow University of Health Sciences, Karachi, Pakistan.
Insights
Continuing aspirin therapy until the day of coronary artery bypass grafting (CABG) surgery does not increase postoperative bleeding. In fact, it may reduce bleeding incidence, contrary to common surgical practice.
Area of Science:
- Cardiovascular Surgery
- Pharmacology
- Anesthesiology
Background:
- Aspirin is often withheld before coronary artery bypass grafting (CABG) due to concerns about increased postoperative bleeding.
- However, evidence suggests continued aspirin therapy reduces myocardial infarction and improves survival post-CABG.
Purpose of the Study:
- To investigate the effect of preoperative aspirin use on postoperative bleeding in patients undergoing CABG.
Main Methods:
- A study involving 30 patients undergoing CABG, divided into two groups.
- Group 1 received aspirin until surgery; Group 2 stopped aspirin 5 days prior.
- Postoperative bleeding was measured up to 76 hours.
Main Results:
- No significant differences in preoperative, intraoperative, or postoperative variables between groups.
- Group 1 (continued aspirin) showed significantly lower bleeding in the 2nd hour post-surgery (p=0.004).
- Group 1 also exhibited significantly lower bleeding between 28-76 hours post-surgery (p=0.043).
Conclusions:
- Contrary to common belief, continuing aspirin until CABG surgery does not elevate postoperative bleeding risk.
- Data indicate a reduction in bleeding incidence when aspirin is not withheld.
- Strong recommendation for the continued use of aspirin up to the day of CABG surgery.
Purpose:
It is not uncommon for aspirin therapy to be withheld before coronary artery bypass grafting (CABG) because it is thought to increase the risk of postoperative bleeding. Many studies have shown that continued aspirin therapy reduces postoperative myocardial infarction and increases survival. The purpose of this study is to analyze the effect of preoperative aspirin on postoperative bleeding in patients undergoing CABG.
Material And Methods:
Patients (n=30) undergoing CABG were divided into two groups, group 1 (n=15) who received aspirin till the day of surgery, and group 2 in whom aspirin was stopped 5 days before surgery. Postoperative bleeding up to 76 h (approximately 3 days) was noted in both groups.
Results:
Preoperative, intraoperative, and postoperative variables were equal in both groups. Postoperative bleeding in the 2nd hour was significantly lower in group 1 compared to group 2 (p=0.004). Bleeding 28-76 h postoperatively was also significantly lower in the first group (p=0.043).
Conclusion:
Our study suggests that contrary to the commonly held beliefs in our setup, the use of aspirin till the date of surgery does not increase the risk of postoperative bleeding after CABG. In contrast, our data show reductions in the bleeding incidence of those in whom aspirin was not withheld prior to surgery. Therefore we strongly recommend its continued use of aspirin until the date of surgery.
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