When should the patient discontinue clopidogrel and aspirin before off pump coronary artery bypass grafting

Objective There has been no agreement to when should the patient discontinue clopidogrel and aspirin before offpump coronary artery bypass grafting(OPCAB). The aim of this study was to retrospectively evaluate the effects of clopidogrel and aspirin on bleeding and use of blood products after OPCAB and to fred the best time to stop the drugs. Methods 146 patients scheduled for OPCAB were divided into three groups: clopidogrel and aspirin discontinued mare than 5 days before surgery(group 1), the drugs discontinued until 3-5 days before surgery(group 2) and both medications continued within 2 days of surgery(goup 3). Chest tube drainage and blood products transfusion requirement and reoperation for bleeding were recorded respectively for statistical analysis. Resalts The mean volume of chest drainage was increased in group 2 (100 ml) than group 1. But the amount of blood products required were similar between the two groups. Group 3 is associated with increased chest drainage of 590ml, and an increase in blood product usage than group 2. No significant difference was found on the rate for re-exploration among the three groups. Conclusion Clopidogrel and aspirin may be continued until 3 to 5 days before surgery in patients undergoing OPCAB.