Effects of Pooled Platelet Concentrate After Coronary Artery Bypass Graft Surgery in Patients With Dual Antiplatelet Therapy.

Abstract

Dual antiplatelet therapy (DAPT) has become standard first-line treatment of acute coronary syndrome; however, it increases the risk of bleeding complications. The aim of this study was to investigate the benefits of pooled platelet concentrate (PPC) in reducing postoperative bleeding in patients undergoing off-pump coronary artery bypass graft (CABG) after a DAPT loading dose. One hundred nine patients who underwent emergent CABG within the first 24 hours after receiving a DAPT loading dose were included in the study and divided into 2 groups: patients who were (group 1, n = 63) and were not (group 2, n = 46) given PPC during the surgery. The amount of bleeding in the postoperative period and the need for blood transfusions were recorded. The mean (SD) surgical drainage amounts were 475.39 (101.94) mL in group 1 and 679.34 (232.03) mL in group 2 (P = .001). The need for surgical revisions was 0% and 15.2% in groups 1 and 2, respectively (P = .002). The median (range) duration of hospitalization after surgery was 4 (4-6) days in group 1 and 6 (4-9) days in group 2 (P = .001). Total transfusions per patient were higher in group 2 than in group 1 (1 [range, 1-4] and 3 [range, 2-7] units, respectively; P = .001). Perioperative PPC in patients who had received DAPT reduces postoperative bleeding, the need for blood products, and hospital stay. As a result, it has beneficial effects for early mobilization and improves patient comfort.