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Published on: September 15, 2023
Effects of Pooled Platelet Concentrate After Coronary Artery Bypass Graft Surgery in Patients With Dual Antiplatelet
1Department of Cardiovascular Surgery, Lokman Hekim University, School of Medicine, Lokman Hekim Akay Hospital, Ankara, Turkey.
Insights
Pooled platelet concentrate (PPC) significantly reduced postoperative bleeding and hospital stay in patients undergoing coronary artery bypass graft (CABG) surgery after dual antiplatelet therapy (DAPT). This intervention improves patient recovery and comfort.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Anesthesiology
Background:
- Dual antiplatelet therapy (DAPT) is standard for acute coronary syndrome but increases bleeding risk.
- Off-pump coronary artery bypass graft (CABG) surgery poses specific challenges for patients on DAPT.
- Effective strategies to mitigate bleeding complications are crucial in this patient population.
Purpose of the Study:
- To evaluate the efficacy of pooled platelet concentrate (PPC) in reducing postoperative bleeding.
- To assess the impact of PPC on blood transfusion requirements and hospital stay.
- To determine the benefits of PPC in patients undergoing emergent CABG after DAPT loading.
Main Methods:
- A prospective study included 109 patients undergoing emergent CABG within 24 hours of DAPT loading.
- Patients were divided into two groups: those receiving PPC during surgery (n=63) and those not (n=46).
- Postoperative bleeding, need for blood transfusions, surgical revisions, and hospitalization duration were recorded.
Main Results:
- Group 1 (with PPC) showed significantly less surgical drainage (475.39 mL vs. 679.34 mL, P=.001).
- No surgical revisions were needed in Group 1 compared to 15.2% in Group 2 (P=.002).
- Hospital stay was shorter in Group 1 (4 days vs. 6 days, P=.001), with fewer transfusions needed.
Conclusions:
- Perioperative pooled platelet concentrate (PPC) effectively reduces postoperative bleeding in patients on DAPT undergoing CABG.
- PPC administration is associated with decreased need for blood products and shorter hospital stays.
- This intervention enhances early mobilization and patient comfort, improving overall outcomes.
Background:
Dual antiplatelet therapy (DAPT) has become standard first-line treatment of acute coronary syndrome; however, it increases the risk of bleeding complications. The aim of this study was to investigate the benefits of pooled platelet concentrate (PPC) in reducing postoperative bleeding in patients undergoing off-pump coronary artery bypass graft (CABG) after a DAPT loading dose.
Methods:
One hundred nine patients who underwent emergent CABG within the first 24 hours after receiving a DAPT loading dose were included in the study and divided into 2 groups: patients who were (group 1, n = 63) and were not (group 2, n = 46) given PPC during the surgery. The amount of bleeding in the postoperative period and the need for blood transfusions were recorded.
Results:
The mean (SD) surgical drainage amounts were 475.39 (101.94) mL in group 1 and 679.34 (232.03) mL in group 2 (P = .001). The need for surgical revisions was 0% and 15.2% in groups 1 and 2, respectively (P = .002). The median (range) duration of hospitalization after surgery was 4 (4-6) days in group 1 and 6 (4-9) days in group 2 (P = .001). Total transfusions per patient were higher in group 2 than in group 1 (1 [range, 1-4] and 3 [range, 2-7] units, respectively; P = .001).
Conclusion:
Perioperative PPC in patients who had received DAPT reduces postoperative bleeding, the need for blood products, and hospital stay. As a result, it has beneficial effects for early mobilization and improves patient comfort.
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