Continuing aspirin causes higher drainage even under full protection with antifibrinolytics

• Published in: The Thoracic and cardiovascular surgeon Vol. 61; no. 8; p. 726
• Main Authors: Al-Lawati, Adil A M, Muthuswamy, Venkatraman
• Format: Journal Article
• Language: English
• Published: Germany 01.12.2013
• Subjects: Adult; Aged; Antifibrinolytic Agents - therapeutic use; Aspirin - administration & dosage; Aspirin - adverse effects; Biomarkers - blood; Blood Transfusion; Coronary Artery Bypass - adverse effects; Coronary Artery Bypass - mortality; Drainage; Drug Administration Schedule; Female; Hemoglobins - metabolism; Humans; Intensive Care Units; Length of Stay; Male; Middle Aged; Platelet Aggregation Inhibitors - administration & dosage; Platelet Aggregation Inhibitors - adverse effects; Platelet Count; Postoperative Hemorrhage - blood; Postoperative Hemorrhage - chemically induced; Postoperative Hemorrhage - mortality; Postoperative Hemorrhage - therapy; Risk Factors; Time Factors; Treatment Outcome
• ISSN: 1439-1902
• DOI: 10.1055/s-0032-1328927

The purpose of this study was to assess the impact of continuation of aspirin on bleeding complications following coronary artery bypass grafting (CABG) surgery operated by a single surgeon. A total of 109 patients underwent isolated, primary, on-pump surgery performed over a 17-month period. These patients were divided into two groups: group 1 (n = 51) received aspirin (81 mg daily) to within 7 days of surgery and group 2 (n = 58) in which aspirin was discontinued > 7 days before surgery. All patients received antifibrinolytic agents. Both groups had identical preoperative characteristics. The aspirin group had significant more drainage and consumed more blood products than the nonaspirin group during the first 12 postoperative hours. However, both groups were similar in terms of: (1) re-exploration rate, (2) requirements for blood transfusion, (3) drop in hemoglobin levels and platelet counts, and (4) length of intensive care unit and hospital stay. Continuing aspirin before CABG is associated with increased blood loss even when used in small doses and under full cover of antifibrinolytic agents. However, this blood loss is not harmful and does not negatively affect the patient's clinical progress.