Related Experiment Video

Updated: Jun 23, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Aspirin plus clopidogrel and risk of infection after coronary artery bypass surgery

Elena Blasco-Colmenares1, Trish M Perl, Eliseo Guallar

  • 1Department of Anesthesiology, Johns Hopkins Hospital, 298 Meyer Bldg, 600 N Wolfe St, Baltimore, MD 21287, USA.

Archives of Internal Medicine
|April 29, 2009
PubMed

Insights

Preoperative dual antiplatelet therapy with aspirin and clopidogrel increases infection risk after coronary artery bypass surgery. This highlights the need for further research into managing antiplatelet medications before surgical procedures.

Area of Science:

  • Cardiology
  • Infectious Disease
  • Surgical Outcomes

Background:

  • The risks of combining aspirin and clopidogrel before surgery are not fully understood.
  • Platelet suppression may elevate postoperative infection risk by impairing hemostasis or immunity.

Purpose of the Study:

  • To investigate the association between preoperative dual antiplatelet therapy (aspirin plus clopidogrel) versus aspirin monotherapy and the incidence of postoperative infection.
  • To analyze the risk of surgical site infection and bacteremia within 30 days following coronary artery bypass surgery.

Main Methods:

  • Retrospective cohort study involving 1677 patients undergoing coronary artery bypass surgery.
  • Comparison of 30-day infection rates between patients receiving dual antiplatelet therapy and those on aspirin monotherapy.
  • Statistical analysis included hazard ratios, confidence intervals, and propensity score adjustments.

Main Results:

  • The 30-day infection incidence was higher with dual antiplatelet therapy (23.1%) compared to aspirin monotherapy (16.1%).
  • Dual antiplatelet therapy remained associated with increased infection risk after adjusting for various risk factors (adjusted HR, 1.42).
  • Higher transfusion rates were observed in the dual antiplatelet therapy group, but transfusion played a minor role in mediating infection risk.

Conclusions:

  • Preoperative aspirin plus clopidogrel use is linked to a higher risk of infection after coronary artery bypass surgery.
  • Further research is needed to clarify the risks and benefits of uninterrupted dual antiplatelet therapy in surgical patients.
  • The impact of platelet inhibition on infectious outcomes, especially in high-risk populations, requires further investigation.
Abstract

Related Concept Videos

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors

Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
Factors Affecting the Risk of Infection01:26

Factors Affecting the Risk of Infection

The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin create...
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...