title: Preoperative continuation of aspirin therapy may improve perioperative saphenous venous graft patency after off-pump coronary artery bypass grafting.
abstract: BACKGROUND
  There is limited information about the effect of preoperative continuation of aspirin therapy on perioperative graft patency in patients undergoing off-pump coronary artery bypass (OPCAB). We sought to evaluate the effect of preoperative continuation of aspirin therapy on perioperative graft patency after OPCAB.
  
  
  METHODS
  Using retrospectively collected data from 582 consecutive patients undergoing first-time isolated OPCAB by a single surgeon at Fuwai Hospital from October 2009 through September 2012, we evaluated the association between aspirin (100 mg daily) preceding OPCAB and the risk of adverse in-hospital postoperative events. The primary outcomes were in-hospital mortality and graft patency. The secondary outcome measures were hemorrhage-related outcomes (reexploration rate, blood transfusions, perioperative drainage loss).
  
  
  RESULTS
  There was no death in the postoperative hospitalization period. Patients receiving preoperative continuation of aspirin therapy (n = 400) had significantly higher postoperative saphenous venous graft patency than did those not receiving preoperative aspirin [98.2% vs 96.1%, p = 0.02]. Multivariate analysis indicated that preoperative discontinuation of aspirin therapy significantly increased the risk of occlusion of saphenous venous graft (odds ratio, 2.193; 95% confidence interval, 1.023 to 4.701, p = 0.043). No significant differences between the two groups were observed in perioperative bleeding risks, including chest tube drainage, blood product transfusion, and reoperation for bleeding.
  
  
  CONCLUSIONS
  This study indicates that preoperative continuation of aspirin therapy may improve perioperative saphenous vein graft patency after OPCAB without increasing the risk of perioperative bleeding.
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Adult Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.
authors.forename: Hengchao
authors.initials: H
authors.lastname: Wu
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Adult Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Adult Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China. Electronic address: shs1505@sina.com.
authors.forename: Hansong
authors.initials: H
authors.lastname: Sun
authors.affiliation: Department of Radiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Lv
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Adult Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.
authors.forename: Xianqiang
authors.initials: X
authors.lastname: Wang
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Adult Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.
authors.forename: Xiaopeng
authors.initials: X
authors.lastname: Hu
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Adult Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.
authors.forename: Weiguo
authors.initials: W
authors.lastname: Ma
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Adult Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
mesh_terms: D001241:Aspirin / Q000008:administration & dosage*; D015331:Cohort Studies; D047549:Coronary Artery Bypass, Off-Pump; D005260:Female; D006083:Graft Occlusion, Vascular / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011300:Preoperative Care; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D014654:Vascular Patency
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin