Key result
Preoperative clopidogrel in off-pump CABG is linked to increased bleeding and ~12-fold higher platelet transfusion risk.
Why the study?
Does preoperative clopidogrel increase bleeding and transfusions in patients undergoing off-pump CABG surgery?
Population
453 patients undergoing off-pump coronary artery bypass graft surgery (OPCAB)
Comparison
Preoperative clopidogrel (n=101) vs No preoperative clopidogrel (n=352)
Design
Cohort
Follow-up
perioperative
Authors
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Supports bleeding risk consideration with preoperative clopidogrel in off-pump CABG; leaves optimal discontinuation timing open for randomized confirmation.
Cohort (n=453)
Does preoperative clopidogrel increase bleeding and transfusions in patients undergoing off-pump CABG surgery?
Absolute Event Rate: 702.24% vs 554.13%
p-value: p=0.03
Discontinuation of clopidogrel at least 72 hours prior to off-pump CABG surgery normalizes bleeding risk to that of patients not on clopidogrel.
Maltais et al. (2008) conducted a cohort in Off-pump coronary artery bypass graft surgery (OPCAB) (n=453). Clopidogrel vs. No clopidogrel was evaluated on Intraoperative bleeding (ml) (p=0.03). Preoperative clopidogrel in off-pump CABG surgery was associated with higher intraoperative bleeding (702.24 ml vs 554.13 ml, p=0.03) and increased risk of platelet transfusions (OR 11.79).
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