Antithrombotic- and anticoagulation regimens in OPCAB surgery. A Nordic survey.
OBJECTIVE
The aim of the survey was to determine current practices for antiplatelet- and heparin therapy in OPCAB surgery in the Nordic countries.


METHODS
A postal survey questionnaire was sent to all 26 departments of Cardiothoracic Surgery in Norway, Sweden, Iceland, Finland, and Denmark.


RESULTS
The overall response rate was 100%. The respondents performed between 130 and 1000 CABG procedures per year. Between 0.3% and 42.0% of these procedures were performed as OPCAB. Preoperative antiplatelet therapy was administered by 48%, while 96% routinely administer postoperative antiplatelet therapy. In the postoperative antiplatelet therapy there was a trend toward a combination of aspirin and low molecular weight heparin. Perioperative anticoagulation practices with heparin varied among departments as well as reversal with protamine. Eighty percent of the respondents register postoperative complications.


CONCLUSIONS
In the Nordic countries there is no uniform practice regarding antiplatelet therapy pre- and postoperatively as well as heparin therapy perioperatively. Dose regimens are highly variable and standard protocols have not yet been developed.
Hansen
Katrine H
KH
Department of Cardiothoracic Surgery, H:S Rigshospitalet, Copenhagen University Hospital, Denmark. katrineha3@m1.stud.ku.dk
Hughes
Pia
P
Steinbrüchel
Daniel A
DA
D000925:Anticoagulants / Q000627:therapeutic use*; D018890:Chemoprevention; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D017723:Drug Utilization Review; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005387:Finland; D019538:Health Care Surveys; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D007055:Iceland; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011182:Postoperative Care / Q000379:methods; D010818:Practice Patterns, Physicians'; D011300:Preoperative Care / Q000379:methods; D012537:Scandinavian and Nordic Countries; D011795:Surveys and Questionnaires
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D010975:Platelet Aggregation Inhibitors