Preoperative Aspirin Use and Its Effect on Adverse Events in Patients Undergoing Cardiac Operations.

Abstract

BACKGROUND:

Preoperative aspirin use within 5 days of cardiac operations is controversial. Aspirin could reduce cardiovascular complications and yet might increase risk of bleeding. Recent reports showed conflicting results, and whether aspirin has variable effects for different cardiac surgical procedures is unclear.

METHODS:

A single-center retrospective cohort analysis was performed. After propensity score matching (PSM) for identified confounders, the relationship between preoperative aspirin use and 30-day all-cause mortality, postoperative renal failure, major adverse cardiocerebral events (MACE), blood transfusion, reoperation for bleeding, and postoperative infection were estimated with separate logistic regression models.

RESULTS:

Preoperative aspirin therapy was associated with a 49% (p = 0.04) increased risk of reoperation for bleeding among 868 matched pairs of patients undergoing valve operations. Among 725 matched patients undergoing coronary artery bypass grafting (CABG), preoperative aspirin therapy was not associated with a statistically significant higher risk of reoperation for bleeding. However, preoperative aspirin use, compared with nonuse, was not associated with risks of MACE, 30-day mortality, postoperative renal failure, blood transfusion, or postoperative infection in the entire cohort, in patients undergoing valve operations only, and in patients undergoing CABG only after PSM.

CONCLUSIONS:

Preoperative aspirin use in all patients undergoing cardiac operations was not associated with risks of major cardiac, cerebral, or renal complications and infections and death; however, the risk of reoperation for bleeding was elevated among preoperative aspirin users compared with nonusers in a subpopulation of patients undergoing valve operations only.

• Authors: Jiapeng Huang, Macarius Donneyong, Jaimin Trivedi, April Barnard, John Chaney, Adam Dotson, Sherri Raymer, Allen Cheng, Hong Liu, Mark S Slaughter
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 99 Issue 6 Pg. 1975-81 (Jun 2015) ISSN: 1552-6259 [Electronic] Netherlands
• PMID: 25912742 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Chemical References

• Platelet Aggregation Inhibitors
• Aspirin

Topics

• Aged
• Aspirin (administration & dosage, adverse effects)
• Blood Transfusion (statistics & numerical data)
• Cardiac Surgical Procedures
• Cause of Death (trends)
• Female
• Follow-Up Studies
• Humans
• Incidence
• Kentucky (epidemiology)
• Male
• Middle Aged
• Platelet Aggregation Inhibitors (administration & dosage, adverse effects)
• Postoperative Hemorrhage (chemically induced, epidemiology, therapy)
• Preoperative Care (methods)
• Propensity Score
• Reoperation (statistics & numerical data)
• Retrospective Studies
• Risk Assessment (methods)
• Survival Rate (trends)