October 9, 2012Heart
Prevalence, indications and appropriateness of antiplatelet therapy in patients operated for acute aortic dissection: associations with bleeding complications and mortality
Key result
Dual antiplatelet therapy at the time of surgery for acute aortic dissection was associated with increased 30-day mortality compared to no or single antiplatelet therapy (30.4% vs 13.0%, p=0.038).
Why the study?
Does ongoing antiplatelet therapy increase bleeding complications and mortality in patients operated for acute aortic dissection type A?
Study Design
Type
Cohort (n=133)
Multicenter
No
Structured PICO
Does ongoing antiplatelet therapy increase bleeding complications and mortality in patients operated for acute aortic dissection type A?
P
Population
133 consecutive patients operated for acute aortic dissection type A at a single center in Western Sweden between 2007 and 2011.
E
Exposure
Ongoing antiplatelet therapy (acetylsalicylic acid alone or acetylsalicylic acid and clopidogrel) at the time of surgery
C
Comparator
No ongoing antiplatelet therapy or single antiplatelet therapy
O
Outcome
Indication and appropriateness of antiplatelet therapy; perioperative bleeding complications, transfusions and mortalitysafety
Main Result
Absolute Event Rate: 30.4% vs 13%
p-value: p=0.038
In patients operated for acute aortic dissection type A, ongoing antiplatelet therapy is often inappropriately administered and is associated with significantly increased bleeding and early mortality.
Authors
Discussion
No takes yet. Share an insight, caveat, or question.
Implication
May warrant caution with dual antiplatelet therapy before acute aortic dissection repair; leaves open need for randomized confirmation of mortality risk.
Cite This Study
Hansson et al. (2012) conducted a cohort in Acute aortic dissection type A (n=133). Dual antiplatelet therapy vs. No or single antiplatelet therapy was evaluated on 30-day mortality (p=0.038). Dual antiplatelet therapy at the time of surgery for acute aortic dissection was associated with increased 30-day mortality compared to no or single antiplatelet therapy (30.4% vs 13.0%, p=0.038).