Effect of aspirin on postoperative bleeding in coronary artery bypass grafting.
OBJECTIVE
It is not uncommon for aspirin therapy to be withheld before coronary artery bypass grafting (CABG) because it is thought to increase the risk of postoperative bleeding. Many studies have shown that continued aspirin therapy reduces postoperative myocardial infarction and increases survival. The purpose of this study is to analyze the effect of preoperative aspirin on postoperative bleeding in patients undergoing CABG.


METHODS
Patients (n=30) undergoing CABG were divided into two groups, group 1 (n=15) who received aspirin till the day of surgery, and group 2 in whom aspirin was stopped 5 days before surgery. Postoperative bleeding up to 76 h (approximately 3 days) was noted in both groups.


RESULTS
Preoperative, intraoperative, and postoperative variables were equal in both groups. Postoperative bleeding in the 2nd hour was significantly lower in group 1 compared to group 2 (p=0.004). Bleeding 28-76 h postoperatively was also significantly lower in the first group (p=0.043).


CONCLUSIONS
Our study suggests that contrary to the commonly held beliefs in our setup, the use of aspirin till the date of surgery does not increase the risk of postoperative bleeding after CABG. In contrast, our data show reductions in the bleeding incidence of those in whom aspirin was not withheld prior to surgery. Therefore we strongly recommend its continued use of aspirin until the date of surgery.
Kamran
Muhammad
M
Department of Cardiac Surgery, Dow University of Health Sciences, Karachi, Pakistan.
Ahmed
Ali
A
Dar
Mudassir Iqbal
MI
Khan
Abdul Bari
AB
D000328:Adult; D001241:Aspirin / Q000008:administration & dosage*; D001777:Blood Coagulation / Q000187:drug effects*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000503:physiopathology*; D013997:Time Factors
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin