Document Detail


Preoperative aspirin therapy is associated with improved postoperative outcomes in patients undergoing coronary artery bypass grafting.
MedLine Citation:
PMID:  16159833     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Aspirin is beneficial in the setting of atherosclerotic cardiovascular disease. There are limited data evaluating preoperative aspirin administration preceding coronary artery bypass grafting and associated postoperative outcomes. METHODS AND RESULTS: Using prospectively collected data from 1636 consecutive patients undergoing first-time isolated coronary artery bypass surgery at our institution from January 2000 through December 2002, we evaluated the association between aspirin usage within the 5 days preceding coronary bypass surgery and risk of adverse in-hospital postoperative events. A logistic regression model, which included propensity scores, was used to adjust for remaining differences between groups. Overall, there were 36 deaths (2.2%) and 48 adverse cerebrovascular events (2.9%) in the postoperative hospitalization period. Patients receiving preoperative aspirin (n=1316) had significantly lower postoperative in-hospital mortality compared with those not receiving preoperative aspirin [1.7% versus 4.4%; adjusted odds ratio (OR), 0.34; 95% CI, 0.15 to 0.75; P=0.007]. Rates of postoperative cerebrovascular events were similar between groups (2.7% versus 3.8%; adjusted OR, 0.67; 95% CI, 0.32 to 1.50; P=0.31). Preoperative aspirin therapy was not associated with an increased risk of reoperation for bleeding (3.5% versus 3.4%; P=0.96) or requirement for postoperative blood product transfusion (adjusted OR, 1.17; 95% CI, 0.88 to 1.54; P=0.28). CONCLUSIONS: Aspirin usage within the 5 days preceding coronary artery bypass surgery is associated with a lower risk of postoperative in-hospital mortality and appears to be safe without an associated increased risk of reoperation for bleeding or need for blood product transfusion.
Authors:
Kevin A Bybee; Brian D Powell; Uma Valeti; A Gabriela Rosales; Stephen L Kopecky; Charles Mullany; R Scott Wright
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  112     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-09-14     Completed Date:  2006-02-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  I286-92     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aspirin / administration & dosage,  therapeutic use*
Cohort Studies
Coronary Artery Bypass / statistics & numerical data*
Coronary Disease / surgery
Drug Administration Schedule
Drug Evaluation
Female
Hospital Mortality
Humans
Male
Middle Aged
Myocardial Infarction / surgery
Platelet Aggregation Inhibitors / administration & dosage,  therapeutic use*
Postoperative Complications / epidemiology
Preoperative Care
Prospective Studies
Retrospective Studies
Stroke / epidemiology
Survival Analysis
Treatment Outcome
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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