Aspirin Reduces Cardiac Surgery Complications

The use of aspirin immediately preceding cardiac surgery significantly reduces the incidence of cardiocerebral ischemic events, according to a new study.

Researchers at Jefferson Medical College (Philadelphia, PA, USA) conducted a retrospective study of 1,879 patients who underwent coronary artery bypass grafting (CABG) between August 2003 and December 2009, to determine the effectiveness of aspirin on postoperative cardiocerebral ischemic events. The researchers excluded patients who had taken preoperative anticoagulants, unknown aspirin use, and those who underwent emergency surgery. The 1,148 patients who met the inclusion criteria were divided into two groups: 860 taking aspirin and 288 patients who did not. There was no significant difference between the groups in baseline parameters, such as body mass index (BMI), preoperative use of digitalis or diuretics, and history of chronic lung disease, cerebrovascular disease, heart failure, cardiogenic shock, or smoking.

The results showed that the patients who had taken aspirin before the surgery were more likely to have used preoperative beta blockers and renin-angiotensin system inhibitors, and were more likely to have a history of hypertension, diabetes, peripheral arterial disease (PAD), previous myocardial infarction (MI), angina, and a family history of coronary artery disease (CAD); they were also more likely to have left main and multiple coronary artery disease, but to have spent less time in cross-clamp and bypass perfusion. An analysis of the results showed that preoperative aspirin use reduced postoperative cardiocerebral ischemic events; there was no significant difference in 30-day mortality between the two groups. The study was presented at the American Society of Anesthesiologists (ASA), held during October 2010 in San Diego (CA, USA).

"Currently, patients are typically advised to stop taking aspirin a week before surgery because of concern about bleeding during an operation,” said lead author and study presenter associate professor of anesthesiology Jian-Zhong Sun, M.D., Ph.D. "The next step will be a randomized multicenter trial on a larger scale to change the recommendation for preoperative medications. But we saw quite a drop in complications. If we can confirm the finding, it will change common practice.”

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Jefferson Medical College