Early aspirin use within 48 hours of coronary bypass surgery was associated with significantly reduced mortality compared to no aspirin (1.3% vs 4.0%, P<0.001).
Cohort (n=5,065)
Yes
Does early aspirin use reduce mortality and ischemic complications in patients undergoing coronary bypass surgery?
Early administration of aspirin within 48 hours after coronary bypass surgery is associated with a significant reduction in mortality and ischemic complications without increasing bleeding or other adverse events.
Absolute Event Rate: 1.3% vs 4%
p-value: p=<0.001
BACKGROUND: There is no therapy known to reduce the risk of complications or death after coronary bypass surgery. Because platelet activation constitutes a pivotal mechanism for injury in patients with atherosclerosis, we assessed whether early treatment with aspirin could improve survival after coronary bypass surgery. METHODS: At 70 centers in 17 countries, we prospectively studied 5065 patients undergoing coronary bypass surgery, of whom 5022 survived the first 48 hours after surgery. We gathered data on 7500 variables per patient and adjudicated outcomes centrally. The primary focus was to discern the relation between early aspirin use and fatal and nonfatal outcomes. RESULTS: During hospitalization, 164 patients died (3.2 percent), and 812 others (16.0 percent) had nonfatal cardiac, cerebral, renal, or gastrointestinal ischemic complications. Among patients who received aspirin (up to 650 mg) within 48 hours after revascularization, subsequent mortality was 1.3 percent (40 of 2999 patients), as compared with 4.0 percent among those who did not receive aspirin during this period (81 of 2023, P<0.001). Aspirin therapy was associated with a 48 percent reduction in the incidence of myocardial infarction (2.8 percent vs. 5.4 percent, P<0.001), a 50 percent reduction in the incidence of stroke (1.3 percent vs. 2.6 percent, P=0.01), a 74 percent reduction in the incidence of renal failure (0.9 percent vs. 3.4 percent, P<0.001), and a 62 percent reduction in the incidence of bowel infarction (0.3 percent vs. 0.8 percent, P=0.01). Multivariate analysis showed that no other factor or medication was independently associated with reduced rates of these outcomes and that the risk of hemorrhage, gastritis, infection, or impaired wound healing was not increased with aspirin use (odds ratio for these adverse events, 0.63; 95 percent confidence interval, 0.54 to 0.74). CONCLUSIONS: Early use of aspirin after coronary bypass surgery is safe and is associated with a reduced risk of death and ischemic complications involving the heart, brain, kidneys, and gastrointestinal tract.
Dennis T. Mangano (2002) conducted a cohort in Coronary bypass surgery (n=5,065). Aspirin vs. No aspirin during the first 48 hours was evaluated on Fatal and nonfatal outcomes (mortality) (p=<0.001). Early aspirin use within 48 hours of coronary bypass surgery was associated with significantly reduced mortality compared to no aspirin (1.3% vs 4.0%, P<0.001).