Effects of preoperative aspirin therapy on early postoperative outcomes in elderly patients undergoing off-pump coronary artery bypass surgery / 中华老年医学杂志

ABSTRACT

Objective To analyze the benefits and risks of preoperative aspirin treatment in elderly patients undergoing off-pump coronary artery bypass (OPCAB) grafting.Methods From January 2010 to June 2014 in Tianjin Chest Hospital,1 501 consecutive patients aged ＞65 years with mean age (71.1 ± 4.2) years who underwent selective first-time isolated off-pump coronary artery bypass surgery were included in this research.They were divided into 2 groupsaspirin group (longterm use of entericcoated aspirin tablets within 5 days before operation,n =369) and aspirin withdrawal group (aspirin withdrawal for 5 days and over before operation,n=1 132).Univariate analysis and a logistic regression were used to compare the postoperative events between the two groups.To adjust for the remaining differences between groups,propensity score was enrolled into the logistic regression model.Results There were no significant differences between the two groups in all-cause in-hospital mortality,postoperative myocardial infarction,cerebrovascular events,postoperative renal failure,blood dialysis and reoperation for bleeding (all P＞＞ 0.05),but more frequency of red blood cell transfusions were found in aspirin group than in aspirin withdrawal group [74.0％(273/369)vs.62.5％(707/1 132),adjusted OR=1.50,95％CI1.13-2.00,P＜0.01].Conclusions Preoperative aspirin treatment can increase the incidence of red blood cell transfusion,but cannot increase the incidence of reoperation for bleeding,and has no effect on the postoperative outcomes such as all-cause in-hospital mortality,cerebrovascular events,postoperative myocardial infarction,postoperative renal failure or blood dialysis in patients undergoing selective isolated OPCAB.