2019
DOI: 10.1055/s-0039-1693122 View full text |Buy / Rent full text
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Abstract: Objectives This study sought to determine (1) the association between the length of preoperative clopidogrel discontinuation, blood loss, and transfusion requirements and (2) whether preoperative platelet function testing predicts excessive postoperative bleeding in patients undergoing coronary artery bypass grafting (CABG) surgery. Methods In this retrospective analysis, patients undergoing CABG were divided into three groups with regard to the period between preoperative clopidogrel cessation and… Show more

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“…The origin of the hemostatic disturbances after cardiac surgery is multifactorial—the effect of the heart‐lung machine (CPB) on platelet function, activated coagulation cascade, heparin‐induced coagulopathy, and fibrinolysis 3 . Postoperative morbidity caused by excessive bleeding is also a consequence of higher blood transfusion rate, as well as mechanisms that are not transfusion‐related 4 …”
Section: Introductionmentioning
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“…The origin of the hemostatic disturbances after cardiac surgery is multifactorial—the effect of the heart‐lung machine (CPB) on platelet function, activated coagulation cascade, heparin‐induced coagulopathy, and fibrinolysis 3 . Postoperative morbidity caused by excessive bleeding is also a consequence of higher blood transfusion rate, as well as mechanisms that are not transfusion‐related 4 …”
Section: Introductionmentioning
“…3 Postoperative morbidity caused by excessive bleeding is also a consequence of higher blood transfusion rate, as well as mechanisms that are not transfusion-related. 4 Furthermore, dual antiplatelet therapy remains the cornerstone of therapy in these patients. There is clear evidence that clopidogrel, ticagrelor, and prasugrel should be discontinued 3, 5, and 7 days before surgery, respectively, so as to prevent perioperative complications caused by coagulation disorders, while aspirin is recommended to be continued until the day of surgery.…”
Section: Introductionmentioning
“…Apparently, there was no need to put in the app whether someone was exposed to Aspirin preoperatively. However, our research group previously con rmed the presence of subset of patients who have prolonged and pronounced platelet inhibitory response to Aspirin (16) , which in turn re ects bleeding tendency. We showed recently that patients with adequate platelet inhibitory response to Aspirin are prone to excessive bleeding (16).…”
Section: Should-not-bleed Score Compared To Other Bleeding Risk Scoresmentioning
“…However, our research group previously con rmed the presence of subset of patients who have prolonged and pronounced platelet inhibitory response to Aspirin (16) , which in turn re ects bleeding tendency. We showed recently that patients with adequate platelet inhibitory response to Aspirin are prone to excessive bleeding (16). Multiplate ASPI test AUC <25 U was found to be predictive of excessive bleeding (OR 2.82 [95% CI 1.43-5.55], p=0.003) which generates the idea about the subset of patients who have pronounced platelet inhibition on Aspirin therapy and who could bene t from preoperative aspirin cessation (16).…”
Section: Should-not-bleed Score Compared To Other Bleeding Risk Scoresmentioning
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