Effects of preoperative aspirin in coronary artery bypass grafting: A double-blind, placebo-controlled, randomized trial

Deja, Marek; Kargul, Tomasz; Domaradzki, Wojciech; Stącel, Tomasz; Mazur, Witold; Wojakowski, Wojciech; Gocoł, Radosław; Gaszewska-Żurek, Ewa; Zurek, Paweł; Pytel, Agata; Woś, Stanisław

doi:10.1016/j.jtcvs.2012.04.004

Cited by 49 publications

(49 citation statements)

References 19 publications

(26 reference statements)

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“…Another criterion for quality assessment used in our analysis was Jadad score calculation and further stratification of the studies in two groups with high and low‐risk for bias. Seven RCTs according to Jadad score were of high quality whereas five RCTs were of low quality. The funnel plots did not find evidence for asymmetry in all performed analyses.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 3922 patients from 12 RCTs and 30 893 patients coming from 28 observational studies met our inclusion criteria and were included in the meta‐analysis. Characteristics of the studies are presented in Tables and .…”

Section: Resultsmentioning

confidence: 99%

“…Seven RCTs reported on postoperative 30‐day mortality with a total of 3362 patients. Pooling the results of RCTs, preoperative aspirin did not show any statistically significant impact on postoperative mortality (OR 1.15; 95%CI 0.65‐2.04; P = 0.62; I 2 = 0%; P heterogeneity = 0.95) (Figure ).…”

Section: Resultsmentioning

confidence: 99%

“…Pooling the results of both RCTs and observational studies, preoperative aspirin showed a significant decrease in postoperative mortality by 29% (OR 0.71; 95%CI 0.6‐0.84; P = 0.0001; I 2 = 7%; P heterogeneity = 0.36). A total of 31 306 patients have been pooled to assess 30‐day mortality of which 93.03% underwent CABG with or without heart valve surgery (Figure ).…”

Section: Resultsmentioning

confidence: 99%

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The use of preoperative aspirin in cardiac surgery: A systematic review and meta-analysis

et al. 2017

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Preoperative aspirin increases the risk for postoperative bleeding. However, this did not result in an increased need for chest re-exploration and did not increase the rates of PRBC transfusion when preoperative low-dose (≤160 mg/d) aspirin was administered. Aspirin at any dose is associated with decreased mortality and AKI and low-dose aspirin (≤160 mg/d) decreases the incidence of perioperative MI.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The use of preoperative aspirin in cardiac surgery: A systematic review and meta-analysis

et al. 2017

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“…4 More recent evidence suggests, however, that ASA use within 5–7 days prior to CABG halves mortality without significant increase in haemorrhage, blood product requirements, or related morbidities 5 and reduces late infarction and repeat revascularization. 6 Retrospective data show consistent benefit of preoperative aspirin within 5 days of surgery, including a reduction in cerebrovascular events and 30-day mortality. 7 …”

Section: Risks and Benefits Of Preoperative Exposure To Antiplatelet mentioning

confidence: 88%

Expert position paper on the management of antiplatelet therapy in patients undergoing coronary artery bypass graft surgery

Sousa-Uva

Storey

Huber

et al. 2014

European Heart Journal

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Use of adenosine diphosphate receptor inhibitor prior to left ventricular assist device implantation is not associated with increased bleeding

Tibrewala

Nassif

Andruska³

et al. 2016

J Artif Organs

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Current guidelines recommend adenosine diphosphate receptor inhibitors (ADPRi) be discontinued 5-7 days prior to cardiac surgery due to increased bleeding events, rates of re-exploration, and transfusions. However, the risks of left ventricular assist device (LVAD) implantation in patients taking an ADPRi have not previously been studied. We retrospectively identified 134 eligible patients with ischemic cardiomyopathy that underwent LVAD implantation between July 2009 and August 2013. The cohorts received an ADPRi ≤5 days of surgery (n = 25) versus >5 days prior or not at all (n = 109). Subgroup analyses adjusted for differences in frequency of redo sternotomy between cohorts, excluded patients that received an ADPRi >1 year prior to surgery, and excluded patients with a redo sternotomy. The ADPRi and control groups did not have significant differences in the primary outcomes, intraoperative PRBC units transfused (3.0 vs. 4.0, p = 0.12) or chest tube output within 24 h of surgery (1.66 L vs. 1.80 L, p = 0.61). After adjusting for differences in frequency of redo sternotomy (ADPRi vs. control, 12 vs. 52%, p ≤ 0.001), no significant difference in PRBC units transfused (3.1 vs. 3.5, p = 0.59) or chest tube output (2.04 L vs. 2.04 L, p = 0.98) was seen. No significant difference in 30-day mortality (8.0 vs. 11.0%, p = 0.63), 90-day mortality (16.4 vs. 23.3%, p = 0.42), or length of stay (29.0 vs. 28.0, p = 0.61) was seen. In this single-center experience, use of an ADPRi ≤5 days prior to LVAD implantation was not associated with increased bleeding, length of stay, or mortality.

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Effects of preoperative aspirin in coronary artery bypass grafting: A double-blind, placebo-controlled, randomized trial

Abstract: Performing coronary grafts on aspirin is associated with increased postoperative bleeding but may decrease the long-term hazard of coronary events.

Cited by 49 publications

References 19 publications

The use of preoperative aspirin in cardiac surgery: A systematic review and meta-analysis

The use of preoperative aspirin in cardiac surgery: A systematic review and meta-analysis

Expert position paper on the management of antiplatelet therapy in patients undergoing coronary artery bypass graft surgery

Use of adenosine diphosphate receptor inhibitor prior to left ventricular assist device implantation is not associated with increased bleeding

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