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
Artículo
en Inglés
| 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.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Resistencia a Medicamentos
/
Inhibidores de Agregación Plaquetaria
/
Puente de Arteria Coronaria
/
Hemorragia Posoperatoria
/
Clopidogrel
Tipo de estudio:
Estudio diagnóstico
/
Estudio de etiología
/
Estudios de evaluación
/
Estudio observacional
/
Estudio pronóstico
/
Factores de riesgo
Límite:
Adulto
/
Anciano
/
Aged80
/
Femenino
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Rev. bras. cir. cardiovasc
Asunto de la revista:
Cardiología
/
Cirugía General
Año:
2018
Tipo del documento:
Artículo
País de afiliación:
Turquía
Institución/País de afiliación:
University of Health Sciences/TR
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