Key result
Recent clopidogrel exposure before urgent or emergent CABG was associated with significantly increased blood loss, transfusion requirements, and reoperation for bleeding.
Why the study?
Does recent clopidogrel exposure increase postoperative blood loss and transfusion requirements in patients undergoing urgent or emergent CABG?
Cohort (n=182)
Does recent clopidogrel exposure increase postoperative blood loss and transfusion requirements in patients undergoing urgent or emergent CABG?
Recent clopidogrel exposure prior to urgent or emergent CABG is associated with significantly increased postoperative blood loss, transfusion requirements, and need for reoperation.
Answers are grounded in this paper and cite their sources.
Suggests caution with recent clopidogrel before urgent CABG; leaves open optimal strategies pending randomized trials.
The aim of this study was to evaluate the effects of clopidogrel on blood loss and blood and blood products usage following CABG. One hundred and ninety-six patients underwent urgent or emergent CABG, 182 of those met with inclusion criteria, 28 patients had clopidogrel exposure (group 1), 49 patients had both ASA and clopidogrel exposure (group 2), and 68 patients had ASA exposure (group 3) within a week of operation. The remaining 37 patients were on no antiaggregant therapy (group 4). Total chest tube drainage during the first 24 h, the incidence of reoperation for bleeding, blood and blood products usage, and the early outcome (duration of mechanical ventilation, the intensive care unit stay and total hospital stay), were assessed. Total chest tube drainage was significantly higher in the patients with clopidogrel exposure and increased amount of transfusions with blood products were also observed in those patients. The patients with clopidogrel exposure required significantly more reoperation for bleeding. The duration of controlled ventilation and intensive care unit stay were also significantly longer in the patients with clopidogrel exposure. Our results support the recent history of clopidogrel treatment associated with increased blood loss, transfusion and reoperation requirement after CABG.
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Feza Nurözler (2005) conducted a cohort in Urgent or emergent CABG (n=182). Clopidogrel vs. ASA alone or no antiaggregant therapy was evaluated on Total chest tube drainage during the first 24 h, incidence of reoperation for bleeding, and blood product usage. Recent clopidogrel exposure before urgent or emergent CABG was associated with significantly increased blood loss, transfusion requirements, and reoperation for bleeding.
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