Comparison of aspirin plus heparin with heparin alone on asymptomatic perioperative deep vein thrombosis in candidates for elective off-pump coronary artery bypass graft: A randomized clinical trial

Mirhosseini, Seyed Jalil; Forouzannia, Seyed Khalil; Mostafavi-Pour-Manshadi, Seyed Mohammad Yousof; Ali-Hasan-Al-Saegh, Sadeq; Naderi, Nafiseh; Sanatkar, Mehdi

doi:10.5603/cj.2013.0026

Cited by 22 publications

(18 citation statements)

References 31 publications

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“…The majority of the studies were observational studies (n=49), 16 studies were RCTs, and 3 were meta‐analyses (Tables 1 and 2). 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84 Of the 16 RCTs identified,1...…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Eight studies reported incidence of bleeding after cardiac surgery, 17,19,25,53,54,78,84 but only 1 study reported risk factors for bleeding after multivariate analysis, with concurrent use of aspirin with systemic anticoagulation as the only significant risk factor in causing bleeding after valvular surgery, with some of these bleeding patients with an international normalized ratio (INR) >5. 53 Although pericardial effusion was common after cardiac surgery (up to 84%), 76 using different doses of enoxaparin (20 vs. 40 mg/day) for VTE prophylaxis after proximal aortic surgery did not affect the incidence of pericardial effusion (19% vs. 21%, respectively) nor the risk of cardiac tamponade requiring surgical interventions.…”

Section: Incidences and Risk Factors For Complications From Vte Prophmentioning

confidence: 99%

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Incidence of Venous Thromboembolism and Benefits and Risks of Thromboprophylaxis After Cardiac Surgery: A Systematic Review and Meta‐Analysis

Bham

Pavey

2015

JAHA

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BackgroundOptimal thromboprophylaxis after cardiac surgery is uncertain. This systematic review aimed to define the incidence and risk factors for deep vein thrombosis (DVT), fatal and nonfatal pulmonary embolism (PE), and assess whether venous thromboembolism (VTE) prophylaxis was effective in reducing VTE without complications after cardiac surgery.Methods and ResultsTwo reviewers independently searched and assessed the quality and outcomes of randomized, controlled trials (RCTs) and observational studies on VTE after cardiac surgery in the MEDLINE, EMBASE, and Cochrane controlled trial register (1966 to December 2014). Sixty‐eight studies provided data on VTE outcomes or complications related to thromboprophylaxis after cardiac surgery. The majority of the studies were observational studies (n=49), 16 studies were RCTs, and 3 were meta‐analyses. VTE prophylaxis was associated with a reduced risk of PE (relative risk [RR], 0.45; 95% confidence interval [CI], 0.28–0.72; P=0.0008) or symptomatic VTE (RR, 0.44; 95% CI, 0.28–0.71; P=0.0006) compared to the control without significant heterogeneity. Median incidence (interquartile range) of symptomatic DVT, PE, and fatal PE were 3.2% (0.6–8.1), 0.6% (0.3–2.9), and 0.3% (0.08–1.7), respectively. Previous history of VTE, obesity, left or right ventricular failure, and prolonged bed rest, mechanical ventilation, or use of a central venous catheter were common risk factors for VTE. Bleeding or cardiac tamponade requiring reoperation owing to pharmacological VTE prophylaxis alone, without systemic anticoagulation, was not observed.ConclusionsUnless proven otherwise by adequately powered RCTs, initiating pharmacological VTE prophylaxis as soon as possible after cardiac surgery for patients who have no active bleeding is highly recommended.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Incidences and Risk Factors For Complications From Vte Prophmentioning

confidence: 99%

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Incidence of Venous Thromboembolism and Benefits and Risks of Thromboprophylaxis After Cardiac Surgery: A Systematic Review and Meta‐Analysis

Bham

Pavey

2015

JAHA

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“…It significantly reduces the bleeding risk for patients with renal insufficiency . A great deal of clinical data have displayed that the combination of antiplatelet agents and anticoagulant agents has more curative effects over antiplatelet agents alone, as well as combinations of adenosine diphosphate (ADP) inhibitor plus FXa inhibitors, aspirin plus heparin, and warfarin plus clopidogrel …”

Section: Introductionmentioning

confidence: 99%

Design, synthesis, and biological evaluation of 4‐methoxy‐3‐arylamido‐N‐(substitutedphenyl)benzamide derivatives as potential antiplatelet agents

Liu

Chen

Qiu

et al. 2019

Archiv der Pharmazie

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A series of 4-methoxy-3-arylamido-N-(substitutedphenyl)benzamides 6a-u were designed according to the splicing principle of structural design in the medicinal chemistry theory and were synthesized in five steps: nitration, acylation, ammoniation, reduction, and secondary ammoniation. The structures of the target compounds were characterized and verified by infrared, 1 H nuclear magnetic resonance (NMR), 13 C NMR, and electron spray ionization spectroscopy. Their in vitro antiplatelet aggregation activities induced by adenosine diphosphate (ADP) or arachidonic acid (AA) were assessed by Born's method. The biological evaluation revealed that all compounds exhibited certain levels of activities in both of the antiplatelet aggregation assays; compounds 6c (IC 50 = 3.84 μM) and 6f (IC 50 = 3.12 μM) displayed the strongest antiplatelet aggregation activities in the ADP-induced and AA-induced assay, separately. Moreover, compounds that had stronger activities were chosen for cell toxicity testing via the cell counting kit-8 assay. The results indicated that none of the compounds had obvious cell toxicity against L929 cells at the doses of 10 and 20 μM. It is worth pointing out that compound 6c showed the highest antiplatelet activity and the lowest cell toxicity. In general, 4-methoxy-3-arylamido-N-(substitutedphenyl)benzamides have the potential to become a kind of safer and more effective antiplatelet agents.

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“…Furthermore, the coagulopathy induced by blood vessel damage may have adverse effect on the reoccurrence of acute coronary heart disease after recovery of blood perfusion. 3) Therefore, timely and accurate prediction of the risk of thrombosis in postoperative OPCAB patients and targeted anticoagulant therapy 4) is important to ease the hypercoagulable state of the patient and lower the incidence of adverse events. Recent studies have showed that, compared with the use of coronary artery bypass graft (CABG) surgery, the time of onset of coagulation activation and fibrinolysis phenomenon was slightly later but more durable.…”

mentioning

confidence: 99%

High Level of von Willebrand Factor in Non-ST Segment Elevation Myocardial Infarction Patients Predicted Cardiovascular Ischemic Events After Off-Pump Coronary Artery Bypass Surgery

Men

Ren

et al. 2015

Int. Heart J.

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The aim of our study was to determine the characteristics and value of plasma von Willebrand factor antigen (vWF: Ag) levels after off-pump coronary artery bypass grafting (OPCAB) surgery in predicting the risk of cardiovascular ischemic events.A retrospective cohort analysis of 203 non-ST-segment elevation myocardial infarction patients was performed. Patients were divided into a poor recovery group and a stable condition group according to whether ischemic events occurred or not within 90 days postoperatively. The level of vWF: Ag was detected using a blood coagulation analyzer. SPSS17.0 statistical software was used for data analysis. The Friedman rank sum test and Mann-Whitney U test were used for intra-group and inter-group data analysis, respectively. The diagnostic performance of vWF: Ag was evaluated by receiver operating characteristic (ROC) curve analysis.Plasma vWF: Ag levels at postoperative days 14, 30, 60, and 90 in the poor recovery group were significantly higher than those at the corresponding time points in the stable group. The area under the ROC curve in diagnosing adverse events was 0.927 (95% CI: 0.867~0.987) with 96.6% sensitivity and 58.6% specificity when the cut-off value of vWF: Ag was 233% at postoperative day 30.The changing characteristics of plasma vWF: Ag sensitively reflect the degree of vascular endothelial injury of OP-CAB patients and might serve as a surrogate marker of the adverse event of non-ST segment elevation myocardial infarction.

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Comparison of aspirin plus heparin with heparin alone on asymptomatic perioperative deep vein thrombosis in candidates for elective off-pump coronary artery bypass graft: A randomized clinical trial

Abstract: Background: Symptomatic or asymptomatic deep vein thrombosis (DVT) is a common complication following coronary artery bypass graft (CABG), in which less than 1% of these patients suffer from clinically evident pulmonary embolism (PE DVT in CABG. (Cardiol J 2013; 20, 2: 139-143)

Cited by 22 publications

References 31 publications

Incidence of Venous Thromboembolism and Benefits and Risks of Thromboprophylaxis After Cardiac Surgery: A Systematic Review and Meta‐Analysis

Incidence of Venous Thromboembolism and Benefits and Risks of Thromboprophylaxis After Cardiac Surgery: A Systematic Review and Meta‐Analysis

Design, synthesis, and biological evaluation of 4‐methoxy‐3‐arylamido‐N‐(substitutedphenyl)benzamide derivatives as potential antiplatelet agents

High Level of von Willebrand Factor in Non-ST Segment Elevation Myocardial Infarction Patients Predicted Cardiovascular Ischemic Events After Off-Pump Coronary Artery Bypass Surgery

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