Key result
Preoperative aspirin intake ≤24 hours before CABG in diabetic patients showed a non-significant trend towards reduced long-term MACCE (HR 0.58; 95% CI 0.31-1.06; P=0.081).
Why the study?
The effect of preoperative aspirin administration on early and long-term clinical outcomes in patients with diabetes mellitus undergoing CABG was not established.
Does continuation of preoperative aspirin ≤ 24 hours before CABG reduce MACCE and mortality in patients with diabetes mellitus?
Observational (n=315)
Does continuation of preoperative aspirin ≤ 24 hours before CABG reduce MACCE and mortality in patients with diabetes mellitus?
Continuing aspirin until ≤ 24 hours before CABG in diabetic patients reduces early MACCE but does not significantly improve long-term outcomes after propensity matching.
Should not yet change preoperative aspirin timing in diabetic CABG patients; leaves open whether early MACCE benefit extends to long-term outcomes.
INTRODUCTION: This study aimed to determine the effect of preoperative aspirin administration on early and long-term clinical outcomes in patients suffering from diabetes mellitus (DM) undergoing coronary artery bypass grafting (CABG). METHODS: In this observational study, a total of 315 patients were included and grouped according to the time interval between their last aspirin dose and the time of surgery; patients who had been continued aspirin intake with last administered dose ≤ 24-hours before CABG (n=144) and those who had been given the last dose of aspirin between 24 to 48 hours before CABG (n=171). RESULTS: Multivariable analysis showed that the continuation of preoperative aspirin intake ≤ 24 hours before CABG in patients with DM is associated with reduced incidence of 30-day major adverse cardiac and cerebral events (MACCE) (P=0.004) as well as reduced incidence of composite 30-day mortality/MACCE (P=0.012). During mean follow-up of 37±17.5 months, the unadjusted hazard ratio (HR) showed that aspirin ≤ 24 hours prior CABG in patients with DM significantly reduced the incidence of MACCE and composite of mortality/MACCE during follow-up (HR: 0.50; 95% confidence interval [CI]: 0.29-0.87; P=0.014 and HR: 0.61; 95% CI: 0.38-0.97; P=0.039, respectively). However, after propensity score (PS) matching, the PS-adjusted HR showed a non-significant trend towards the reduction of MACCE during follow-up (HR: 0.58; 95% CI: 0.31-1.06; P=0.081). CONCLUSION: Continuation of preoperative aspirin intake ≤ 24 hours before CABG in patients with DM is associated with reduced incidence of early MACCE, but without significant influence on long-term outcomes.
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Aboul‐Hassan et al. (2020) conducted an observational in Diabetes mellitus undergoing coronary artery bypass grafting (CABG) (n=315). Preoperative aspirin intake ≤ 24 hours before CABG vs. Aspirin intake between 24 to 48 hours before CABG was evaluated on MACCE during follow-up (HR 0.58, 95% CI 0.31-1.06, p=0.081). Preoperative aspirin intake ≤24 hours before CABG in diabetic patients showed a non-significant trend towards reduced long-term MACCE (HR 0.58; 95% CI 0.31-1.06; P=0.081).
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