title: Effect of preoperatively continued aspirin use on early and mid-term outcomes in off-pump coronary bypass surgery: a propensity score-matched study of 1418 patients.
abstract: BACKGROUND
  To date, effect of preoperatively continued aspirin administration in off-pump coronary artery bypass grafting (CABG) is less known. We aimed to assess the effect of preoperatively continued aspirin use on early and mid-term outcomes in patients receiving off-pump CABG.
  
  
  METHODS
  From October 2009 to September 2013 at the Fuwai Hospital, 709 preoperative aspirin users were matched with unique 709 nonaspirin users using propensity score matching to obtain risk-adjusted outcome comparisons between the two groups. Early outcomes were in-hospital death, stroke, intra- and post-operative blood loss, reoperation for bleeding and blood product transfusion. Major adverse cardiac events (death, myocardial infarction or repeat revascularization), angina recurrence and cardiogenic readmission were considered as mid-term endpoints.
  
  
  RESULTS
  There were no significant differences among the groups in baseline characteristics after propensity score matching. The median intraoperative blood loss (600 ml versus 450 ml, P = 0.56), median postoperative blood loss (800 ml versus 790 ml, P = 0.60), blood transfusion requirements (25.1% versus 24.4%, P = 0.76) and composite outcome of in-hospital death, stroke and reoperation for bleeding (2.8% versus 1.6%, P = 0.10) were similar in aspirin and nonaspirin use group. At about 4 years follow-up, no significant difference was observed among the aspirin and nonaspirin use group in major adverse cardiac events free survival estimates (95.7% versus 91.5%, P = 0.23) and freedom from cardiogenic readmission (88.5% versus 85.3%, P = 0.77) whereas the angina recurrence free survival rates was 83.7% and 73.9% in the aspirin and nonaspirin use group respectively (P = 0.02), with odd ratio for preoperative aspirin estimated at 0.71 (95% confidence interval, 0.49-1.04, P = 0.08).
  
  
  CONCLUSIONS
  Preoperatively continued aspirin use was not associated with increased risk of intra- and post-operative blood loss, blood transfusion requirements and composite outcome of in-hospital death, stroke and reoperation for bleeding in off-pump CABG. Preoperative aspirin use tended to decrease the hazard of mid-term angina recurrence.
authors.affiliation: Department of Cardiovascular Surgery, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital and Cardiovascular Institute, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Fucheng
authors.initials: F
authors.lastname: Xiao
authors.affiliation: Department of Cardiovascular Surgery, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital and Cardiovascular Institute, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Hengchao
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Cardiovascular Surgery, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital and Cardiovascular Institute, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Hansong
authors.initials: H
authors.lastname: Sun
authors.affiliation: Department of Cardiovascular Surgery, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital and Cardiovascular Institute, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Shiwei
authors.initials: S
authors.lastname: Pan
authors.affiliation: Department of Cardiovascular Surgery, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital and Cardiovascular Institute, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Cardiovascular Surgery, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital and Cardiovascular Institute, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Yunhu
authors.initials: Y
authors.lastname: Song
mesh_terms: D000368:Aged; D001241:Aspirin / Q000009:adverse effects* / Q000627:therapeutic use; D047549:Coronary Artery Bypass, Off-Pump / Q000401:mortality*; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology*; D057216:Propensity Score; D012086:Reoperation; D020521:Stroke / Q000209:etiology*; D016896:Treatment Outcome
chemical_list: D001241:Aspirin