Abstract
Background and ObjectivePostoperative cardiocerebral and renal complications are a major threat for patients undergoing cardiac surgery. This study was aimed to examine the effect of preoperative aspirin use on patients undergoing cardiac surgery.MethodsAn observational cohort study was performed on consecutive patients (n = 1879) receiving cardiac surgery at this institution. The patients excluded from the study were those with preoperative anticoagulants, unknown aspirin use, or underwent emergent cardiac surgery. Outcome events included were 30-day mortality, renal failure, readmission and a composite outcome - major adverse cardiocerebral events (MACE) that include permanent or transient stroke, coma, perioperative myocardial infarction (MI), heart block and cardiac arrest.ResultsOf all patients, 1145 patients met the inclusion criteria and were divided into two groups: those taking (n = 858) or not taking (n = 287) aspirin within 5 days preceding surgery. Patients with aspirin presented significantly more with history of hypertension, diabetes, peripheral arterial disease, previous MI, angina and older age. With propensity scores adjusted and multivariate logistic regression, however, this study showed that preoperative aspirin therapy (vs. no aspirin) significantly reduced the risk of MACE (8.4% vs. 12.5%, odds ratio [OR] 0.585, 95% CI 0.355–0.964, P = 0.035), postoperative renal failure (2.6% vs. 5.2%, OR 0.438, CI 0.203–0.945, P = 0.035) and dialysis required (0.8% vs. 3.1%, OR 0.230, CI 0.071–0.742, P = 0.014), but did not significantly reduce 30-day mortality (4.1% vs. 5.8%, OR 0.744, CI 0.376–1.472, P = 0.396) nor it increased readmissions in the patients undergoing cardiac surgery.ConclusionsPreoperative aspirin therapy is associated with a significant decrease in the risk of MACE and renal failure and did not increase readmissions in patients undergoing non-emergent cardiac surgery.
Highlights
Tremendous progress has been made in the field of cardiac surgery over the past four decades, major cerebral, cardiac and renal complications associated with cardiac surgery remain common and significant [1]–[3]
No significant differences were evident between two groups in body mass index (BMI), medical history, clinical pattern, and preoperative medical therapy
The major findings from this observational cohort study are that preoperative use of aspirin is associated with a significant decrease in the risk of postoperative major adverse cardiocerebral (MACE) (8.4% vs. 12.5%), renal failure (2.6% vs. 5.2%) and dialysis required (0.8% vs. 3.1%), it is not associated with increased risk of readmissions in patients undergoing non-emergent cardiac surgery
Summary
Tremendous progress has been made in the field of cardiac surgery over the past four decades, major cerebral, cardiac and renal complications associated with cardiac surgery remain common and significant [1]–[3]. There is still lacking of an effective clinical therapy to prevent these major cardiocerebral and renal complications. Early postoperative aspirin therapy has been applied to improve postoperative outcomes in patients undergoing CABG, including improved graft patency, a reduced risk of death and ischemic complications [8]–[13]. It remains to be determined about whether preoperative aspirin therapy can reduce major adverse cardiocerebral (MACE) and renal events in patients undergoing cardiac surgery [14]–[16]. Postoperative cardiocerebral and renal complications are a major threat for patients undergoing cardiac surgery. This study was aimed to examine the effect of preoperative aspirin use on patients undergoing cardiac surgery
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