• Ann. Thorac. Surg. · Feb 2015

    Preoperative continuation of aspirin therapy may improve perioperative saphenous venous graft patency after off-pump coronary artery bypass grafting.

    • Hengchao Wu, Jian Wang, Hansong Sun, Bin Lv, Xianqiang Wang, Xiaopeng Hu, Weiguo Ma, and Jing Zhang.
    • State Key Laboratory of Cardiovascular Disease, Department of Adult Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.
    • Ann. Thorac. Surg. 2015 Feb 1; 99 (2): 576-80.

    BackgroundThere is limited information about the effect of preoperative continuation of aspirin therapy on perioperative graft patency in patients undergoing off-pump coronary artery bypass (OPCAB). We sought to evaluate the effect of preoperative continuation of aspirin therapy on perioperative graft patency after OPCAB.MethodsUsing retrospectively collected data from 582 consecutive patients undergoing first-time isolated OPCAB by a single surgeon at Fuwai Hospital from October 2009 through September 2012, we evaluated the association between aspirin (100 mg daily) preceding OPCAB and the risk of adverse in-hospital postoperative events. The primary outcomes were in-hospital mortality and graft patency. The secondary outcome measures were hemorrhage-related outcomes (reexploration rate, blood transfusions, perioperative drainage loss).ResultsThere was no death in the postoperative hospitalization period. Patients receiving preoperative continuation of aspirin therapy (n = 400) had significantly higher postoperative saphenous venous graft patency than did those not receiving preoperative aspirin [98.2% vs 96.1%, p = 0.02]. Multivariate analysis indicated that preoperative discontinuation of aspirin therapy significantly increased the risk of occlusion of saphenous venous graft (odds ratio, 2.193; 95% confidence interval, 1.023 to 4.701, p = 0.043). No significant differences between the two groups were observed in perioperative bleeding risks, including chest tube drainage, blood product transfusion, and reoperation for bleeding.ConclusionsThis study indicates that preoperative continuation of aspirin therapy may improve perioperative saphenous vein graft patency after OPCAB without increasing the risk of perioperative bleeding.Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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