Effect of preoperative aspirin use on mortality in coronary artery bypass grafting patients.
BACKGROUND
Discontinuing aspirin use in patients before coronary artery bypass grafting (CABG) has focused on bleeding risks. The effect of aspirin use on overall mortality with this procedure has not been studied.


METHODS
We performed a case patient-control patient study of the 8,641 consecutive isolated CABG procedures performed between July 1987 and May 1991 in Maine, New Hampshire, and Vermont. Patients included all 368 deaths. Each case patient was paired with approximately two matched survivors (control patients). Aspirin use was defined by identification of ingestion within 7 days before the operation.


RESULTS
CABG patients using preoperative aspirin were less likely to experience in-hospital mortality in univariate (odds ratio [OR] = 0.73, 95% confidence interval [0.54, 0.97]) and multivariate [OR = 0.55, (0.31, 0.98)] analysis compared to nonusers. No significant difference was seen in the amount of chest tube drainage, transfusion of blood products, or need for reexploration for hemorrhage between patients who did and did not receive aspirin.


CONCLUSIONS
Preoperative aspirin use appears to be associated with a decreased risk of mortality in CABG patients without significant increase in hemorrhage, blood product requirements, or related morbidities.
Dacey
L J
LJ
Department of Surgery, Center for the Evaluative Clinical Sciences, Community & Family Medicine, Lebanon, New Hampshire, USA. lawrence.j.dacey@dartmouth.edu
Munoz
J J
JJ
Johnson
E R
ER
Leavitt
B J
BJ
Maloney
C T
CT
Morton
J R
JR
Olmstead
E M
EM
Birkmeyer
J D
JD
O'Connor
G T
GT
D000368:Aged; D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects; D016022:Case-Control Studies; D002423:Cause of Death; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009511:New England; D011183:Postoperative Complications / Q000401:mortality*; D011292:Premedication; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data; D015996:Survival Rate
D001241:Aspirin