Impact of clopidogrel antiplatelet therapy on surgical outcome in selected patient populations

Abstract

Objectives The aim of the study is to evaluate the impact of antiplatelet therapy (APT) on surgical outcome of patients requiring emergency surgery while on APT and on that of patients assigned for elective surgery and had stopped their APT for 1 week before surgery. Patients and methods This selective study included 30 patients on aspirin alone (ASP group), 30 patients on clopidogrel alone (CLO group), and 30 patients receiving both (combination group); in addition, 30 patients without any history of APT (control group) and 30 patients on combined APT and assigned to elective major surgeries who discontinued APT for 7 days before surgery were also included. Results The study included 150 patients with a mean age of 59.6±7.3 years; range: 43–78 years. Patients who received APT showed significantly greater amounts of blood loss during and at 12 h after surgery, with a concomitantly significantly higher number of blood units consumed compared with the control group. Patients of the CLO group showed the least deviation from the elective group. The combination group showed significantly greater blood loss and a higher need for blood transfusion compared with both the CLO and the elective group. Patients of the ASP group showed significantly higher blood loss and more need for transfusion therapy compared with the elective group. Conclusion Elective stoppage of APT for 7 day before surgery, if not hazardous, is advisable. Emergency surgical procedure for patients maintained on chronic APT is not so harmful despite the increased need for transfusions, but the outcome is best in those receiving CLO alone.