Key result
The potential influence of microthrombosis involving platelets in postoperative complications after cardiac surgery has been underappreciated, and the use of perioperative antiplatelet therapy remains limited.
Why the study?
Does perioperative antiplatelet therapy prevent ischemic complications in patients undergoing coronary artery bypass grafting surgery?
Does perioperative antiplatelet therapy prevent ischemic complications in patients undergoing coronary artery bypass grafting surgery?
This review highlights the underappreciated role of platelet-mediated microthrombosis in postoperative ischemic complications after CABG and suggests a potential need to reevaluate the limited use of perioperative antiplatelet therapy.
Should not yet change perioperative antiplatelet practice in CABG; hypothesis-generating for targeted trials on platelet microthrombosis.
PURPOSE OF REVIEW: This review addresses the role of platelets in perioperative ischemic complications involving the brain, kidneys, and gastrointestinal tract, and long-term survival in patients undergoing coronary artery bypass grafting surgery. Importantly, findings of several recent clinical studies will be discussed with emphasis on platelet activation and leukocyte inflammatory responses as important mediators of vascular microthrombosis and ischemic injury. RECENT FINDINGS: Our recent findings suggest that in some patients, the hemostatic balance during and after surgery may shift toward a hypercoagulable state and contribute to acute organ failure. SUMMARY: For over 6 decades, major postoperative complications after cardiac surgery have remained unchanged. The potential influence of microthrombosis involving platelets has been underappreciated and use of perioperative antiplatelet therapy remains very limited - primarily because of a culture of fear of bleeding.
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Vasquez et al. (2017) conducted a review in Perioperative ischemic complications in patients undergoing coronary artery bypass grafting surgery. Perioperative antiplatelet therapy was evaluated on Perioperative ischemic complications and long-term survival. The potential influence of microthrombosis involving platelets in postoperative complications after cardiac surgery has been underappreciated, and the use of perioperative antiplatelet therapy remains limited.
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