Preoperative Aspirin Use and Its Effect on Adverse Events in Patients Undergoing Cardiac Operations

Huang, Jiapeng; Donneyong, Macarius; Trivedi, Jaimin R.; Barnard, April; Chaney, John; Dotson, Adam; Raymer, Sherri; Cheng, Allen; Liu, Hong; Slaughter, Mark S.

doi:10.1016/j.athoracsur.2015.02.032

Cited by 13 publications

(9 citation statements)

References 29 publications

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“…Our previous study showed preoperative aspirin use was correlated with higher rate of reoperation due to bleeding in valve surgery, but not in CABG surgery. 10 A meta-analysis found that preoperative aspirin increased the need for transfusion of blood products for patients undergoing CABG. 11 Late or no cessation of aspirin was suggested to decrease the risk of stroke in patients undergoing CABG.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Functional Platelet Number Is Inversely Associated With 30-Day Mortality After Cardiac Surgery: A Retrospective Cohort Study

Ghosal

Trivedi

Barlowe

et al. 2020

Semin Cardiothorac Vasc Anesth

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Background. We hypothesize that preoperative functional platelet number (platelet count multiplied by platelet aggregation percentage) are associated with 30-day mortality after cardiac surgery. Methods. We linked our preoperative testing database with the STS (Society of Thoracic Surgeon) database to form a study cohort of 1390 patients who had cardiac surgeries between January 2008 and December 2013. Preoperative tests of platelet count and platelet aggregation were routinely performed on all cardiac surgical patients within 24 hours before entering the operating room. Multiple logistic regression models were used to determine whether functional platelet number are associated with 30-day mortality, modified composite major adverse cardiocerebral events, postoperative renal failure or requirement for new renal replacement therapy, and reoperation for bleeding. Log-linear models were used to examine whether functional platelet numbers are associated with hospital length of stay and intensive care unit length of stay. Results. Functional platelet number had an inverse association with 30-day mortality, and each 50 × 109/L increase in functional platelet number resulted in decreased 30-day mortality (odds ratio of 0.767 with 95% confidence interval = 0.591-0.996). For secondary outcomes, functional platelet number was neither associated with major adverse cardiocerebral event nor length of stay. However, we found that each 50 × 109/L increase in functional platelet number was associated with decreased reoperations for bleeding (odds ratio of 0.778 with 95% confidence interval = 0.636-0.951). Conclusions. The preoperative functional platelet number had significant associations with 30-day mortality after cardiac surgery. Functional platelet number could be used to guide timing of cardiac surgery, especially as more and more patients are receiving antiplatelet medications nowadays.

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Section: Discussionmentioning

confidence: 99%

Preoperative Functional Platelet Number Is Inversely Associated With 30-Day Mortality After Cardiac Surgery: A Retrospective Cohort Study

Ghosal

Trivedi

Barlowe

et al. 2020

Semin Cardiothorac Vasc Anesth

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“…The current study is a single-institution retrospective analysis of 5,385 patients, of whom 3,871 (72.2%) patients received preoperative aspirin while 1,711 (27.8%) did not [1]. The authors studied the entire cohort and subdivided the group into coronary artery bypass graft (CABG)-only and valve-only patients to understand further what effect preoperative aspirin use might have on adverse events (eg, bleeding, mortality, renal failure, cerebrovascular…”

Section: Invited Commentarymentioning

confidence: 99%

Invited Commentary

Hicks

2015

The Annals of Thoracic Surgery

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“…Another retrospective cohort study of 3,585 patients indicated that preoperative aspirin therapy was associated with renal protection and mortality decline for patients with chronic kidney disease undergoing cardiac surgery (87). Recently, A single-center retrospective cohort analysis of 9,903 consecutive patients undergoing cardiac operations showed that preoperative aspirin use was associated with lower risks of postoperative renal failure (OR, 0.91) in CABG surgery, and was not statistically significantly different in valve operations (88). A 2 × 2 factorial randomized, blinded, clinical trial of 6, 905 patients demonstrated that perioperative aspirin administration did not reduce the risk of AKI (adjusted relative risk, 1.10; 95% CI, 0.96–1.25) among patients undergoing major noncardiac surgery (89).…”

Section: Strategies To Prevent Akimentioning

confidence: 99%

Prevention and Treatment of Cardiac Surgery Associated Acute Kidney Injury

Cheng¹,

Sun²,

Ji³

et al. 2016

J Anesth Perioper Med

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Aim of review:Acute kidney injury (AKI) after cardiac surgery is a relatively common postoperative complication and is independently related to increased mortality and morbidity.Method:In this review, we will focus on risk factors of developing AKI, early detection by biomarkers and preventive strategies for AKI after adult cardiac surgery.Recent findings:Many perioperative factors affect renal function and acute AKI following cardiac surgery. Novel biomarkers of kidney injury such as neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), cystatin C (CysC), have the potential to facilitate the early diagnosis of cardiac surgery associated AKI (CSA-AKI). Pharmacological interventions have been inconsistent to their efficacy, and to date, there is no compelling pharmacologic agent known to reduce the risk of AKI or treat established AKI.Summary:Preventive strategies of AKI focus on optimal perioperative management.

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Preoperative Aspirin Use and Its Effect on Adverse Events in Patients Undergoing Cardiac Operations

Cited by 13 publications

References 29 publications

Preoperative Functional Platelet Number Is Inversely Associated With 30-Day Mortality After Cardiac Surgery: A Retrospective Cohort Study

Preoperative Functional Platelet Number Is Inversely Associated With 30-Day Mortality After Cardiac Surgery: A Retrospective Cohort Study

Invited Commentary

Prevention and Treatment of Cardiac Surgery Associated Acute Kidney Injury

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