Impact of aspirin on bleeding and blood product usage in off‐pump and on‐pump coronary artery bypass graft surgery
Abstract Major bleeding is linked to poorer outcomes following cardiac surgery. Current guidelines recommend continuation of aspirin prior to coronary artery by‐pass graft (CABG) but the effect of continuing aspirin in patients with prior indication for aspirin, in particular during off‐pump CABG (O...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-05-01
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| Series: | eJHaem |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jha2.400 |
| _version_ | 1797739975627767808 |
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| author | Christopher Little Zain Odho Richard Szydlo Tuan‐Chen Aw Mike Laffan Deepa R. J. Arachchillage |
| author_facet | Christopher Little Zain Odho Richard Szydlo Tuan‐Chen Aw Mike Laffan Deepa R. J. Arachchillage |
| author_sort | Christopher Little |
| collection | DOAJ |
| description | Abstract Major bleeding is linked to poorer outcomes following cardiac surgery. Current guidelines recommend continuation of aspirin prior to coronary artery by‐pass graft (CABG) but the effect of continuing aspirin in patients with prior indication for aspirin, in particular during off‐pump CABG (OPCABG), has not been systematically assessed. In this study, we analysed the effect of continuing aspirin prior to OPCABG and on‐pump CABG with respect to bleeding and blood product usage. We compared propensity‐matched cohorts of patients who continued aspirin until the day of OPCABG or CABG to controls (no antiplatelet) and to patients discontinuing aspirin 5–7 days prior. Length of hospital stay, 30‐day mortality and thromboembolism rates were similar for both OPCABG and CABG. During OPCABG, aspirin‐continued patients received more intraoperative red cell units compared to controls without difference in bleeding. Aspirin‐continued patients received more blood products perioperatively and bled more than aspirin‐discontinued patients undergoing OPCABG. The only difference during CABG was a small increase in the volume of cells salvaged among aspirin‐continued patients compared to controls. Current guidelines on the continuation of aspirin prior to CABG and OPCABG are safe. Continuation of aspirin prior to OPCABG may result in more bleeding and blood product usage. |
| first_indexed | 2024-03-12T14:05:54Z |
| format | Article |
| id | doaj.art-991f1a0ce85b4629b3ab6bbb172a03bb |
| institution | Directory Open Access Journal |
| issn | 2688-6146 |
| language | English |
| last_indexed | 2024-03-12T14:05:54Z |
| publishDate | 2022-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | eJHaem |
| spelling | doaj.art-991f1a0ce85b4629b3ab6bbb172a03bb2023-08-21T14:11:09ZengWileyeJHaem2688-61462022-05-013231732510.1002/jha2.400Impact of aspirin on bleeding and blood product usage in off‐pump and on‐pump coronary artery bypass graft surgeryChristopher Little0Zain Odho1Richard Szydlo2Tuan‐Chen Aw3Mike Laffan4Deepa R. J. Arachchillage5Centre for Haematology, Department of Immunology and Inflammation Imperial College London London UKDepartment of Biochemistry, Royal Brompton & Harefield Hospitals Part of Guy's & St Thomas’ NHS Foundation Trust London UKCentre for Haematology, Department of Immunology and Inflammation Imperial College London London UKDepartment of Anaesthesia Royal Brompton Hospital & Harefield NHS Foundation Trust London UKCentre for Haematology, Department of Immunology and Inflammation Imperial College London London UKCentre for Haematology, Department of Immunology and Inflammation Imperial College London London UKAbstract Major bleeding is linked to poorer outcomes following cardiac surgery. Current guidelines recommend continuation of aspirin prior to coronary artery by‐pass graft (CABG) but the effect of continuing aspirin in patients with prior indication for aspirin, in particular during off‐pump CABG (OPCABG), has not been systematically assessed. In this study, we analysed the effect of continuing aspirin prior to OPCABG and on‐pump CABG with respect to bleeding and blood product usage. We compared propensity‐matched cohorts of patients who continued aspirin until the day of OPCABG or CABG to controls (no antiplatelet) and to patients discontinuing aspirin 5–7 days prior. Length of hospital stay, 30‐day mortality and thromboembolism rates were similar for both OPCABG and CABG. During OPCABG, aspirin‐continued patients received more intraoperative red cell units compared to controls without difference in bleeding. Aspirin‐continued patients received more blood products perioperatively and bled more than aspirin‐discontinued patients undergoing OPCABG. The only difference during CABG was a small increase in the volume of cells salvaged among aspirin‐continued patients compared to controls. Current guidelines on the continuation of aspirin prior to CABG and OPCABG are safe. Continuation of aspirin prior to OPCABG may result in more bleeding and blood product usage.https://doi.org/10.1002/jha2.400aspirinbleedingcoronary artery bypass graftthromboembolismtransfusion |
| spellingShingle | Christopher Little Zain Odho Richard Szydlo Tuan‐Chen Aw Mike Laffan Deepa R. J. Arachchillage Impact of aspirin on bleeding and blood product usage in off‐pump and on‐pump coronary artery bypass graft surgery eJHaem aspirin bleeding coronary artery bypass graft thromboembolism transfusion |
| title | Impact of aspirin on bleeding and blood product usage in off‐pump and on‐pump coronary artery bypass graft surgery |
| title_full | Impact of aspirin on bleeding and blood product usage in off‐pump and on‐pump coronary artery bypass graft surgery |
| title_fullStr | Impact of aspirin on bleeding and blood product usage in off‐pump and on‐pump coronary artery bypass graft surgery |
| title_full_unstemmed | Impact of aspirin on bleeding and blood product usage in off‐pump and on‐pump coronary artery bypass graft surgery |
| title_short | Impact of aspirin on bleeding and blood product usage in off‐pump and on‐pump coronary artery bypass graft surgery |
| title_sort | impact of aspirin on bleeding and blood product usage in off pump and on pump coronary artery bypass graft surgery |
| topic | aspirin bleeding coronary artery bypass graft thromboembolism transfusion |
| url | https://doi.org/10.1002/jha2.400 |
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