• Cardiol J · Jan 2007

    The effect of preoperative aspirin use on postoperative bleeding and perioperative myocardial infarction in patients undergoing coronary artery bypass surgery.

    • Mohammad Hassan Ghaffarinejad, Amir Farjam Fazelifar, Shahram Mohajer Shirvani, Esmaeel Asdaghpoor, Farzad Fazeli, Hamid Reza Bonakdar, and Freidoun Noohi.
    • Cardiol J. 2007 Jan 1; 14 (5): 453-7.

    BackgroundWe tried to evaluate the clinical outcomes (mortality, postoperative bleeding and perioperative myocardial infarction) of patients who underwent first elective coronary artery bypass grafting and received aspirin during the preoperative period.MethodsThe study was a prospective, randomized and single-blinded clinical trial. Two hundred patients were included and divided into two groups. One group received aspirin 80-160 mg, while in the other aspirin was stopped at least seven days before surgery. The primary end-points of the study were in-hospital mortality and hemorrhage-related complications (postoperative blood loss in the intensive care unit, re-exploration for bleeding and red blood cell and non-red blood cell requirements). The secondary end-point was perioperative myocardial infarction.ResultsThere were no differences in patient characteristics between the aspirin users and non-aspirin users. We found a significant difference between postoperative blood loss (608 +/- +/- 359.7 ml vs. 483 +/- 251.5 ml; p = 0.005) and red blood cell product requirements (1.32 +/- +/- 0.97 unit packed cell vs. 0.94 +/- 1.02 unit packed cell; p = 0.008). There was no significant difference between the two groups regarding platelet requirement and the rate of in-hospital mortality and re-exploration for bleeding. Similarly, we found no significant difference in the incidence of definite and probable perioperative myocardial infarction (p = 0.24 and p = 0.56 respectively) or in-hospital mortality between the two groups.ConclusionPreoperative aspirin administration increased postoperative bleeding and red blood cell requirements with no effect on mortality, re-exploration rate and perioperative myocardial infarction. We recommend withdrawal of aspirin seven days prior to surgery. (Cardiol J 2007; 14: 453-457).

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