Key result
Continuing aspirin before off-pump CABG is not linked to increased postoperative blood loss versus stopping.
Why the study?
Does continuing aspirin perioperatively increase post-operative blood loss or complications in patients undergoing off-pump CABG?
Observational (n=48)
No
Does continuing aspirin perioperatively increase post-operative blood loss or complications in patients undergoing off-pump CABG?
Continuing aspirin perioperatively in off-pump CABG appears safe and does not significantly increase post-operative bleeding or transfusion requirements.
Answers are grounded in this paper and cite their sources.
May support continuing aspirin in off-pump CABG without excess bleeding; hypothesis-generating and requires RCT confirmation.
Introduction: Aspirin, the most widely used platelet function inhibitor extremely effective at blocking the production of thromboxane in platelets, rendering the platelets incapable of functioning normally, and thus preventing thrombosis. The practice of empirically discontinuing aspirin preoperatively should be abandoned because evidence strongly supports continued use of aspirin in patients for secondary prevention of CAD, CVD, or PVD when undergoing surgery.Methods and Materials: This Observational study was conducted at Department of Cardiac Surgery, NICVD, Dhaka, who underwent off pump CABG (OPCAB), divided in two groups, Group A: 24 patients who stopped and Group B: 24 patients who are continuing aspirin throughout the perioperative period. Post operative blood loss, requirement of blood transfusion, post-operative MI, ICU stay, Total hospital stay (days) and early post-operative complication (Stroke, New arrhythmia in ECG, 30 days mortality) were recorded and included in the study.Results: The key finding of the present study is that preoperatively continued aspirin use was not associated with increased risk of post-operative blood loss, blood transfusion requirements and need for re exploration after OPCAB.Conclusions: Preoperative aspirin therapy should be continued till off-pump CABG without interruption.
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Karim et al. (2018) conducted an observational in Off-pump Coronary Artery Bypass Grafting (OPCAB) (n=48). Preoperative aspirin continuation vs. Aspirin discontinuation 5 days before operation was evaluated on Post-operative blood loss up to removal of drain tubes (ml) (p=0.643). Preoperatively continued aspirin use in patients undergoing off-pump CABG was not associated with an increased risk of post-operative blood loss compared to stopping aspirin 5 days before surgery.
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