Key result
Preoperative aspirin did not improve early vein graft occlusion compared to starting 6 hours post-CABG (7.4% vs 7.8%; p=0.871) but increased the reoperation rate for bleeding (6.3% vs 2.4%; p=0.036).
Why the study?
Does preoperative aspirin improve early saphenous vein graft patency compared to postoperative aspirin in patients undergoing coronary artery bypass grafting?
Population
Patients undergoing coronary artery bypass grafting (CABG). Primary endpoint analyzed in n=351.
Comparison
Aspirin 325 mg administered the night before… vs Matching placebo administered the night before…
Design
RCT, randomized, double-blind, placebo-controlled
Follow-up
average of 8 days
Authors
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Aspirin started 6 hours post-CABG achieves early graft patency comparable to pre-op dosing; extends evidence supporting flexible perioperative timing to minimize bleeding.
RCT (n=351)
double-blind
randomized
Yes
Does preoperative aspirin improve early saphenous vein graft patency compared to postoperative aspirin in patients undergoing coronary artery bypass grafting?
Absolute Event Rate: 7.4% vs 7.8%
p-value: p=0.871
Starting aspirin before CABG increases bleeding complications without improving early vein graft patency compared to starting aspirin 6 hours postoperatively.
Goldman et al. (1991) conducted an RCT in coronary artery bypass grafting (n=351). Aspirin before operation vs. Placebo before operation, then aspirin 325 mg 6 hours after operation was evaluated on early (7-10-day) saphenous vein graft patency (occlusion rate) (p=0.871). Preoperative aspirin did not improve early vein graft occlusion compared to starting 6 hours post-CABG (7.4% vs 7.8%; p=0.871) but increased the reoperation rate for bleeding (6.3% vs 2.4%; p=0.036).
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