Background: Despite the fact that aspirin is of benefit to patients following coronary artery bypass grafting (CABG), continuation or administration of preoperative aspirin before CABG or any cardiac surgical procedure remains controversial. Therefore, we performed a systematic review and meta-analysis to assess the influence of preoperative aspirin administration on patients undergoing cardiac surgery.
Materials And Methods: Medline database was searched using OVID SP interface. Similar searches were performed separately in EMBASE, PubMed, and Cochrane Central Registry of Controlled Trials.
Results: Twelve randomized controlled trials and 28 observational studies met our inclusion criteria and were included in the meta-analysis. The use of preoperative aspirin in patients undergoing CABG at any dose is associated with reduced early mortality as well as a reduced incidence of postoperative acute kidney injury (AKI). Low-dose aspirin (≤160 mg/d) is associated with a decreased incidence of perioperative myocardial infarction (MI). Administration of preoperative aspirin at any dose in patients undergoing cardiac surgery increases postoperative bleeding. Despite this effect of preoperative aspirin, it did not increase the rates of surgical re-exploration due to excessive postoperative bleeding nor did it increase the rates of packed red blood cell transfusions (PRBC) when preoperative low-dose aspirin (≤160 mg/d) was administered.
Conclusions: Preoperative aspirin increases the risk for postoperative bleeding. However, this did not result in an increased need for chest re-exploration and did not increase the rates of PRBC transfusion when preoperative low-dose (≤160 mg/d) aspirin was administered. Aspirin at any dose is associated with decreased mortality and AKI and low-dose aspirin (≤160 mg/d) decreases the incidence of perioperative MI.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/jocs.13250 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Preoperative estimated glomerular filtration rate to predict cardiac events in major noncardiac surgery: a secondary analysis of two large international studies.
Br J Anaesth
January 2025
Population Health Research Institute, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada.
Background: Optimised use of kidney function information might improve cardiac risk prediction in noncardiac surgery.
Methods: In 35,815 patients from the VISION cohort study and 9219 patients from the POISE-2 trial who were ≥45 yr old and underwent nonurgent inpatient noncardiac surgery, we examined (by age and sex) the association between continuous nonlinear preoperative estimated glomerular filtration rate (eGFR) and the composite of myocardial injury after noncardiac surgery, nonfatal cardiac arrest, or death owing to a cardiac cause within 30 days after surgery. We estimated contributions of predictive information, C-statistic, and net benefit from eGFR and other common patient and surgical characteristics to large multivariable models.
Impact of acetylsalicylic acid on perioperative bleeding complications in deceased donor kidney transplantation.
World J Urol
January 2025
Department of Urology, Charité - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
Purpose: The objective of this study was to evaluate the perioperative outcomes and complications associated with the use of acetylsalicylic acid (ASA) in deceased donor kidney transplantation (KTX), with a particular focus on bleeding events.
Methods: We retrospectively analyzed 157 kidney transplant recipients (KTRs) who underwent KTX at Charité Berlin, Department for Urology, between February 2014 and December 2017. Patients were divided into two groups: patients with ASA in their preoperative medication (Group A, n = 59) and patients without ASA use (Group B, n = 98).
Efficacy of Aspirin in Preventing Venous Thromboembolism in Total Knee and Hip Joint Replacement.
Cureus
November 2024
Orthopedics and Traumatology, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado, Puebla, MEX.
Background: Venous thromboembolism (VTE) is a significant complication following total knee arthroplasty (TKA) and total hip arthroplasty (THA). Aspirin has gained attention as a cost-effective, safe alternative to traditional anticoagulants like enoxaparin, but comparative data on efficacy and safety remain limited.
Methods: This randomized controlled trial compared the efficacy of aspirin and enoxaparin in preventing VTE following TKA and THA.
Perioperative aspirin and coronary artery bypass graft surgery: An updated meta-analysis of randomized controlled trials.
Surgery
December 2024
Discipline of Surgery, University of Adelaide, Adelaide, Australia; Australian Safety and Efficacy Register of New Interventional Procedures-Surgical, Royal Australasian College of Surgeons, Adelaide, Australia; Research, Audit and Academic Surgery, Royal Australasian College of Surgeons, Adelaide, Australia.
Background: The decision to continue aspirin before elective coronary artery bypass graft surgery remains contentious because of competing thrombotic and bleeding risks. We performed a contemporary systematic review and meta-analysis to compare outcomes between patients undergoing coronary artery bypass grafting who stopped and continued aspirin before surgery.
Methods: PubMed, MEDLINE, and CENTRAL databases were searched from inception to 4 October 2023 for randomized controlled trials comparing patients undergoing coronary artery bypass grafting who continued preoperative aspirin with those who discontinued before surgery.
Association of Same-day Antiplatelet Loading and Outcomes after TransCarotid Artery Revascularization.
J Vasc Surg
December 2024
Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis, IN.
Objective: Prior studies have emphasized the importance of compliance with preoperative dual antiplatelet therapy (DAPT) in patients undergoing TransCarotid artery revascularization (TCAR). This investigation examines differences in perioperative outcomes following TCAR in those receiving loading dose of antiplatelet medications on the day of the procedure versus those already maintained on DAPT.
Methods: Consecutive TCAR procedures from the Vascular Quality Initiative (2016-2022) were identified.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!