Importancia del tiempo de suspensión del uso combinado de aspirina y clopidogrel en pacientes sometidos a cirugía de revascularización coronaria / Importance of the time for stopping the combined use of aspirin and clopidogrel in patients undergoing coronary artery by-pass graft surgery
Arch. cardiol. Méx
;
78(2): 178-186, abr.-jun. 2008.
Article
in Spanish
| LILACS
| ID: lil-567650
ABSTRACT
The combined use of aspirin and clopidogrel is the standard of care for patients with acute coronary syndromes. The risk for perioperative bleeding is considerably increased after coronary artery by-pass graft surgery (CABG). This study was designed to evaluate the effect of antiplatelet therapy on perioperative CABG outcome. We studied 49 consecutive patients undergoing first time CABG, and compared two groups Group A, patients who stopped antiplatelet treatment at least 6 days before surgery, and group B, those who received antiplatelet therapy within 5 days before surgery or did not suspended therapy. The groups were comparable in their demographic characteristics, manifestations of disease, perioperative medication use and the characteristics of surgery. There was a non significant tendency for more cardiovascular complications (primary cardiovascular endpoint) in the group that stopped antiplatelet therapy 6 or more days before surgery (Group A 12%, group B 8%; p = 0.923). The bleeding endpoint was significantly higher in group B, that remained on antiplatelet therapy within 5 days before surgery (Group A 4%, group B 29%; p = 0.023), as well as the need for transfusion. We concluded that the combined use of aspirin and clopidogrel before CABG increases postoperative bleeding and morbidity; there was no definitive difference in the cardiovascular outcome.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Ticlopidine
/
Platelet Aggregation Inhibitors
/
Aspirin
/
Coronary Artery Bypass
Type of study:
Controlled clinical trial
/
Observational study
/
Risk factors
Limits:
Female
/
Humans
/
Male
Language:
Spanish
Journal:
Arch. cardiol. Méx
Journal subject:
Cardiology
Year:
2008
Type:
Article
Affiliation country:
Mexico
Institution/Affiliation country:
Hospital Central Dr. Ignacio Morones Prieto/MX
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