ABSTRACT
Background : Low molecular weight heparins are replacing unfractionated heparin in practice prior to cardiac surgery. This study examines postoperative [post-op] bleeding indicators in patients who received enoxaparin and underwent elective isolated first time coronary artery bypass graft
Methods: A total of 125 consecutive patients who underwent this procedure between 2009 and 2011 at one tertiary center were reviewed and divided into three groups : Group A[n = 50] received the last dose of enoxaparin between 12 and 24 hours before surgery, Group B [n = 25] received the last dose before 24 hours and Group C [n = 50] did not receive enoxaparin. Perioperative bleeding indicators and transfusion rates were compared
Results : Preoperative patients' characteristics were comparable between the three groups. There were no perioperative deaths, return to the operating room for any reason, nor major bleeding. Post-op bleeding indicators were similar in the three groups. The average chest tube drainage at 24 hours post-op was 880 mL, 695 mL and 830 mL in Group A, B and C respectively [p = 0.71]. Transfusion rates of red blood cells were not statistically different [Group A 56%, B 64% and C 62% ; p = 0.747]. In multivariate analysis, female gender, older age, and preoperative clopidogrel intake [stopped 5 days prior to surgery] were associated with higher transfusion rates
Conclusion: In elective first time coronary artery bypass graft patients who had no aspirin or clopidogrel intake 5 days prior to surgery, the use of enoxaparin up to 12 hours prior to skin incision does not increase the risk of post-op bleeding