دورية أكاديمية
Is continuation of antiplatelets until coronary artery bypass safe in Asians?
| العنوان: | Is continuation of antiplatelets until coronary artery bypass safe in Asians? |
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| المؤلفون: | Vu TD; Department of Surgery, National University of Singapore, Singapore., Zaw MH; Department of Surgery, National University of Singapore, Singapore., Chang G; Department of Cardiac, Thoracic and Vascular Surgery, National University Health System, Singapore., Hu SL; Department of Surgery, National University of Singapore, Singapore., Tay CW; Department of Cardiac, Thoracic and Vascular Surgery, National University Health System, Singapore., Ng CW; Department of Surgery, National University of Singapore, Singapore., Chia DK; Department of Surgery, National University of Singapore, Singapore., Lee CN; Department of Surgery, National University of Singapore, Singapore Department of Cardiac, Thoracic and Vascular Surgery, National University Health System, Singapore., Kofidis T; Department of Surgery, National University of Singapore, Singapore Department of Cardiac, Thoracic and Vascular Surgery, National University Health System, Singapore surtk@nus.edu.sg. |
| المصدر: | Asian cardiovascular & thoracic annals [Asian Cardiovasc Thorac Ann] 2014 Oct; Vol. 22 (8), pp. 909-18. Date of Electronic Publication: 2014 Jan 27. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Sage Country of Publication: England NLM ID: 9503417 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1816-5370 (Electronic) Linking ISSN: 02184923 NLM ISO Abbreviation: Asian Cardiovasc Thorac Ann Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Feb. 2009- : London : Sage Original Publication: Chen Yuan, Republic of Singapore : Asia Pub. EXchange, |
| مواضيع طبية MeSH: | Asian People* , Coronary Artery Bypass*/adverse effects , Coronary Artery Bypass*/mortality, Coronary Artery Disease/*therapy , Platelet Aggregation Inhibitors/*administration & dosage, Aged ; Blood Loss, Surgical/prevention & control ; Blood Transfusion ; Coronary Artery Disease/blood ; Coronary Artery Disease/diagnosis ; Coronary Artery Disease/ethnology ; Coronary Artery Disease/mortality ; Drug Administration Schedule ; Female ; Humans ; Male ; Middle Aged ; Platelet Aggregation Inhibitors/adverse effects ; Postoperative Hemorrhage/chemically induced ; Postoperative Hemorrhage/therapy ; Retrospective Studies ; Risk Factors ; Singapore ; Time Factors ; Treatment Outcome |
| مستخلص: | Background: Controversies have arisen about the risks of discontinuing antiplatelets prior to coronary artery bypass grafting. Methods: We retrospectively studied the effects of different strategies of antiplatelet discontinuation prior to coronary artery bypass on perioperative bleeding and major adverse cardiovascular events in Asian patients in a single center in Singapore. Results: 402 patients were divided into 4 groups: group A had no antiplatelets before surgery; antiplatelets were stopped for 5-7 days in group B; 2-4 days in group C; and 0-1 day in group D. Compared to group B, group D had longer intensive care unit stays and more intraoperative transfusions of blood (p = 0.006) and blood products (p < 0.05). The 1-year major adverse cardiovascular event rate was higher in groups A and D (p = 0.027). Stopping antiplatelets within 24 h of surgery was one of multiple independent predictors of intraoperative transfusion but not the 1-year major adverse cardiovascular event rate. Patients on aspirin alone had less intraoperative transfusion of platelets and postoperative minor bleeding than those on combined therapy. Conclusion: Continuation of antiplatelets until 2 days before coronary artery bypass in Asian patients in our institution is unlikely to increase the risks of bleeding and perioperative transfusion. Taking antiplatelets within 24 h of surgery seems to be associated with a higher rate of 1-year major adverse cardiovascular events and bleeding, and an increased risk of blood product transfusion. Thirty-day and 1-year major adverse cardiovascular event rates were higher in patients without antiplatelet treatment. (© The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.) |
| فهرسة مساهمة: | Keywords: Blood loss; Coronary artery bypass; Platelet aggregation inhibitors; Postoperative hemorrhage; surgical |
| المشرفين على المادة: | 0 (Platelet Aggregation Inhibitors) |
| تواريخ الأحداث: | Date Created: 20140304 Date Completed: 20150604 Latest Revision: 20221207 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1177/0218492314521421 |
| PMID: | 24585288 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1816-5370 |
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| DOI: | 10.1177/0218492314521421 |