AI Article Synopsis
- The study assessed the safety and outcomes of patients who continued dual antiplatelet therapy (DAPT) with Clopidogrel and aspirin up to coronary artery bypass grafting (CABG) compared to those on aspirin alone.
- The research included 240 patients, revealing that those on DAPT experienced more infections and longer hospital stays post-surgery, but had similar rates of bleeding, redo surgeries, and in-hospital deaths as the control group.
- The findings suggest that it is safe for patients at high risk of myocardial infarction to remain on DAPT until surgery, especially when prophylactic platelet transfusions are administered.
Article Abstract
Background: Guidelines suggest that patients discontinue Clopidogrel at least 5 days prior to coronary artery bypass grafting (CABG). Those with acute coronary syndrome (ACS) are at high risk for myocardial infarction (MI) if not treated with dual antiplatelet therapy (DAPT). We sought to assess pre and post-operative outcomes of patients maintained on Clopidogrel and aspirin up to the time of surgery and compare them with those on aspirin alone.
Methods: From the cardiac surgery database, 240 patients were retrospectively registered between January and May 2017. There were 126 patients with ACS who underwent CABG on DAPT (Clopidogrel group [CG]) and 114 patients who underwent elective CABG on aspirin alone (control). The CG received intraoperative prophylactic platelet transfusion (PPT). Demographics, comorbidities, and laboratory data were prospectively entered at the time of surgery and were subsequently retrieved for analysis. Per and postoperative findings were identified and compared between both groups.
Results: The cohort consisted of 240 patients (mean age 61 years, 81.3% were male, SD ± 9.58). Patients in the CG were younger (Median 57 vs. 63, P-value 0.001), and with male predominance (86% versus 75%, P-value 0.028). In addition, they had less prevalence for diabetes and renal failure as compared to control (P-values 0.003, and 0.005, respectively). There were no significant differences between both groups in number of vessels grafts, duration of on-pump and aortic clamp. Hematologic laboratory data had also similar baseline values. The CG had similar bleeding rate, redo surgery and in-hospital death (P-values non-significant), however more infection and total hospital stay as compared to control (p-values 0.048 and 0.001).
Conclusion: Patients who are at increased risk for MI can be maintained on DAPT up to the time of CABG because surgery is safe when patients are offered PPT.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880414 | PMC |
| http://dx.doi.org/10.1186/s13019-019-1028-2 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A Comparison of Different Machine Learning Classifiers in Predicting Xerostomia and Sticky Saliva due to Head and Neck Radiotherapy using a Multi-objective, Multimodal Radiomics Model.
Biomed Phys Eng Express
January 2025
Radiation Oncology, Emory University, Emory Midtown Hospital, Atlanta, Georgia, 30322, UNITED STATES.
Although radiotherapy techniques are the primary treatment for head and neck cancer (HNC), they are still associated with substantial toxicity, and side effect. Machine learning (ML) based radiomics models for predicting toxicity mostly rely on features extracted from pre-treatment imaging data. This study aims to compare different models in predicting radiation-induced xerostomia and sticky saliva in both early and late stage of HNC patients using CT and MRI image features along with demographics and dosimetric information.
View Article and Find Full Text PDFThe influence of sociodemographic and health factors on adherence to home-based rehabilitation after fast-track total knee arthroplasty: secondary analysis of a randomized controlled trial.
Disabil Rehabil
January 2025
Clinic Institute of Medical and Surgical Specialties (ICEMEQ), Hospital Clinic of Barcelona, Barcelona, Spain.
Purpose: Adherence to home rehabilitation following total knee arthroplasty (TKA) is essential to reach optimal functional outcomes, especially in fast-track procedures. The aim of this study is to identify which sociodemographic and health factors significantly affect adherence in this context.
Methods: This is a secondary analysis of a randomized controlled trial with 52 patients.
EEG-derived brainwave patterns for depression diagnosis via hybrid machine learning and deep learning frameworks.
Appl Neuropsychol Adult
January 2025
Faculty Xavier Institute of Engineering, Mahim, India.
In the fields of engineering, science, technology, and medicine, artificial intelligence (AI) has made significant advancements. In particular, the application of AI techniques in medicine, such as machine learning (ML) and deep learning (DL), is rapidly growing and offers great potential for aiding physicians in the early diagnosis of illnesses. Depression, one of the most prevalent and debilitating mental illnesses, is projected to become the leading cause of disability worldwide by 2040.
View Article and Find Full Text PDFHand-Assisted Laparoscopic Surgery (HALS) as an Alternative to Unplanned Laparoscopic Conversion to Open Surgery (LCOS) in Colectomies for Acute Diverticulitis.
Surg Innov
January 2025
Morristown Medical Center, Department of Surgery, Morristown, NJ, USA.
Background: In difficult colorectal cases, surgeons may opt for a hand-assisted laparoscopic (HALS) colectomy or attempt a laparoscopic surgery that may require an unplanned conversion to open (LCOS). We aimed to compare the clinical outcomes of these 2 types of surgeries.
Methods: Colectomies for acute diverticulitis with a HALS or LCOS surgery were selected from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) 2022 Targeted Colectomy Database.
The natural history of cytologically low-risk indeterminate thyroid nodules.
J Clin Endocrinol Metab
January 2025
Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy.
Background: Thyroid nodules classified cytologically as low-risk indeterminate lesions (TIR3A) on fine-needle aspiration biopsy (FNAB) present a clinical challenge due to their uncertain malignancy risk. This single-center study aimed to evaluate the natural history of TIR3A nodules.
Materials And Methods: FNABs performed between July 2017 and December 2019 were retrospectively retrieved and patients with TIR3A nodules were evaluated at baseline and throughout a follow-up based on ultrasound (US) parameters and clinical data.
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!