Is preoperative clopidogrel resistance a predictor of bleeding and risks in patients undergoing emergency cabg surgery?
Rev. bras. cir. cardiovasc
;
33(4): 330-338, July-Aug. 2018. tab, graf
Article
in English
| LILACS
| ID: biblio-958435
ABSTRACT
Abstract Objective:
The aims of this study were to determine whether the detection of preoperative clopidogrel resistance in patients undergoing cardiac surgery while using clopidogrel could play a guiding role in the prediction of postoperative excessive bleeding, transfusion requirements, and risks and to provide clinically significant data.Methods:
Two hundred and twenty-two patients [median age 59.4 (38-83) years; 38 females] undergoing emergency and elective coronary artery bypass graft (CABG) surgeries in our clinic were evaluated prospectively. Patients with multiple systemic diseases, other than diabetes mellitus (DM) and hypertension (HT), were excluded. Patients receiving clopidogrel were also evaluated for clopidogrel resistance and grouped according to the results of this test. Assessments of platelet functions were performed by multiplate impedance aggregometry method and adenosine diphosphate test.Results:
The use of postoperative fresh blood replacement and platelet transfusion was higher in patients receiving clopidogrel than in those not receiving it (P=0.001, P=0.018). DM, HT, myocardial infarction, and the number of presentation to the emergency room were significantly higher in patients receiving clopidogrel than in those not receiving it (P<0.05). No significant difference was determined between patients with and without clopidogrel resistance regarding the amount of bleeding during and after surgery, erythrocyte suspension and fresh-frozen plasma transfusion rates, preoperative troponin values, ejection fraction values, and length of hospital stays (P>0.05).Conclusion:
We think that resistance studies in patients receiving clopidogrel before cardiac surgery are not efficient to predict bleeding and bleeding-related complications in patients undergoing emergency and elective CABG surgeries.
Full text:
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Index:
LILACS (Americas)
Main subject:
Drug Resistance
/
Platelet Aggregation Inhibitors
/
Coronary Artery Bypass
/
Postoperative Hemorrhage
/
Clopidogrel
Type of study:
Diagnostic study
/
Etiology study
/
Evaluation studies
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
English
Journal:
Rev. bras. cir. cardiovasc
Journal subject:
Cardiology
/
General Surgery
Year:
2018
Type:
Article
Affiliation country:
Turkey
Institution/Affiliation country:
University of Health Sciences/TR
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