Efficacy and Safety of Coronary Artery Bypass Grafting Without Stopping Pre-operative Aspirin Administration：A Meta Analysis / 中国循环杂志

ABSTRACT

Objective: To systemically evaluate the efifcacy and safety of coronary artery bypass grafting (CABG) without stopping pre-operative aspirin administration for anti-platelet therapy in relevant patients. Methods: The computer searching including Cochrane Library (Issue 2, 2014), PubMed, EMbase, CBM, CNKI, WanFang Data and VIP was conducted to collect the randomized controlled trial (RCT) for CABG without stopping pre-operative aspirin administration from the data base establishment until 2014-07. There were 2 reviewers identiifed the literatures independently according to inclusion, exclusion criteria, and extracted the information, evaluated the quality of assessment methods, then meta-analysis was performed by RevMan 5.2 software. Results: A total of 8 RCT studies including 1945 patients were enrolled. The meta analysis showed that compared with stopping pre-operative aspirin administration, the patients without stopping pre-operative aspirin had obviously increased post-operative bleeding drainage as MD=235.97,P=0.01, re-operation for bleeding as OR=2.4,P=0.0005 and fresh frozen plasma transfusion requirement as MD=0.79,P<0.0001. While the packed red blood cell (PRBC) transfusion requirement as MD=0.66, P=0.05, platelet transfusion requirement as MD=0.99,P=0.25, the incidence rate of post-operative myocardial infarction as OR=1.03,P=0.90 and post-operative mortality (OR=1.24,P=0.56) were similar between two conditions. Conclusion: CABG without stopping pre-operative aspirin administration may increase the post-operative bleeding,transfusion and re-operation for bleeding; low dose aspirin administration before CABG needs further investigation to solve the above problems in clinical practice.