Perioperative effect of acetylsalicylic acid stoppage duration before coronary artery bypass grafting

Abstract

ObjectiveTo assess the effect of timing of preoperative cessation of aspirin therapy on perioperative morbidity and mortality in patients undergoing coronary artery bypass graft (CABG) surgery.BackgroundAspirin is used for primary or secondary prevention of thrombotic complications. It inhibits platelet function and so there is an increased risk of hemorrhage among patients undergoing CABG. Aspirin discontinuation time before CABG surgery has been a controversy for years. We aimed at assessing the effect of timing of preoperative cessation of aspirin therapy on perioperative morbidity and mortality in patients undergoing CABG surgery.Patients and methodsSixty patients having coronary artery disease and indicated for CABG surgery were included. Patients were randomly allocated into two groups: group A (32 patients) patients received 100 mg (enteric coated aspirin)/day till the day of surgery and group B (28 patients) patients received aspirin 100 mg daily until 5 days before surgery. We followed postoperative hemodynamics, morbidity, and mortality for 30 days after surgery.ResultsGroup A had significantly lesser ICU stay, duration of inotropic support, and duration of mechanical ventilation than the other group. However, the need of intraoperative and postoperative blood transfusion, reopening for bleeding, postoperative myocardial infarction, and 30 days mortality were similar between the two groups.ConclusionsLate use of aspirin till the day of surgery in small doses was associated with less ICU stay and earlier weaning from mechanical ventilation and was not associated with increased risk of bleeding, increased need for blood transfusion nor increased rates of reoperation for bleeding. Hence, we can conclude that late aspirin use is recommended especially in high-risk patients