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Aspirin does not increase bleeding and allogeneic blood transfusion in coronary artery surgery
1Division of Cardiac Surgery, Department of General Surgery, Princess Muna Al-Hussein Cardiac Center, King Abdullah University Hospital - Faculty of Medicine/Jordan University of Science and Technology, Irbid, Jordan. emad_hijazi@hotmail.com
Insights
Continuing aspirin therapy until the day of surgery does not increase bleeding or the need for blood transfusions in patients undergoing coronary artery bypass surgery. This finding challenges traditional practice regarding aspirin cessation before cardiac procedures.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Pharmacology
Background:
- Traditional practice dictates stopping aspirin seven days before coronary artery bypass surgery (CABS) to mitigate postoperative bleeding risks.
- This study investigates the impact of preoperative aspirin administration on bleeding outcomes in CABS patients.
Purpose of the Study:
- To evaluate the effect of continuing aspirin therapy until the day of surgery versus stopping it seven days prior on bleeding complications in elective coronary artery bypass surgery.
Main Methods:
- A prospective, nonrandomized, unblinded study involving 756 patients undergoing elective CABS.
- Patients were divided into two groups: one group continued 100 mg/day aspirin until surgery, while the other stopped aspirin seven days preoperatively.
- Outcomes measured included chest tube drainage, blood product transfusion requirements, and reexploration rates for bleeding.
Main Results:
- No statistically significant differences were observed between the groups regarding the amount of blood loss.
- The number of transfused blood products and the incidence of reexploration for bleeding did not significantly differ between patients who continued aspirin and those who stopped it.
- P values were greater than 0.05 for all comparisons, indicating no significant increase in bleeding complications.
Conclusions:
- Continuing aspirin therapy up to the day of coronary artery bypass surgery does not appear to increase postoperative bleeding.
- The findings suggest that aspirin does not elevate the need for allogeneic blood transfusions in this patient population.
- This challenges the conventional approach of routinely discontinuing aspirin before CABS.
Background:
Traditionally, the administration of aspirin is stopped seven days before coronary artery bypass surgery to reduce the risk of postoperative bleeding. The aim of this study was to evaluate the effect of preoperative aspirin on bleeding in these patients.
Methods:
A prospective nonrandomized unblinded study was carried out at the King Abdullah University Hospital in Jordan/Irbid from June 2005 to December 2009 in 756 patients. Patients were divided into 2 groups: Group 1 (n = 400) consisted of patients on aspirin, 100 mg/day, until the day of surgery; Group 2 (n = 356) consisted of patients who stopped taking aspirin seven days before surgery. The groups were compared to evaluate the effect of preoperative aspirin on bleeding in patients undergoing elective coronary artery bypass surgery. Data were collected and compared and included total amount of postoperative chest tube drainage, number of transfused units of blood and blood products, and numbers of patients who required reexploration for bleeding. Results were considered significant when P < 0.05.
Results:
There was no significant increase in the amount of blood loss, units of transfused blood products, or the incidence of reexploration between the two groups ( P > 0.05).
Conclusion:
Aspirin does not increase bleeding or increase the need for allogeneic blood transfusion in coronary artery surgery.
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