Adenosine Diphosphate Receptor Inhibitors: Balancing Perioperative Bleeding and Protection From Adverse Coronary Events

Abstract

In this issue of The Annals of Thoracic Surgery, Voetsch and colleagues1 describe an observational study of the relationship between preoperative withdrawal time of 3 adenosine diphosphate-platelet receptor (P2Y12 receptor) antagonists (prasugrel, ticagrelor, and clopidogrel) and bleeding outcomes after cardiac operations. They studied 299 coronary artery bypass grafting ± valve patients whose dual-antiplatelet therapy was discontinued within 7 days of operation and measured red blood cell loss and Bleeding Academic Research Consortium type 4 (CABG-related bleeding within 48 hours) bleeding outcomes in these patients.