The association between platelet transfusion and adverse outcomes after coronary artery bypass surgery.
OBJECTIVE
Previous research suggests that platelet transfusion is associated with adverse events after coronary artery bypass grafting (CABG). The aim of the current analysis was to verify this hypothesis.


METHODS
Data from 6745 consecutive patients undergoing CABG from 2006 through 2012 were collected. Patients receiving platelet transfusions intraoperatively or postoperatively in the intensive care unit were compared with control patients. To adjust for possible confounders, propensity score matching and conditional regression analyses were performed. Short-term outcomes were 30-day mortality, in-hospital myocardial infarction and stroke. Mid-term outcomes were 6-month mortality, and need for coronary angiography or repeat coronary revascularization within 6 months after surgery. Data were retrieved from the Western Denmark Heart Registry.


RESULTS
Using propensity scores, 982 patients exposed to platelets were matched with 982 control patients. Platelet transfusion was associated with a higher rate of postoperative coronary angiography (adjusted odds ratio 2.34, 95% confidence interval 1.15-4.76). There was no significant association between platelet transfusion and postoperative mortality, myocardial infarction, stroke and need for repeat coronary revascularization.


CONCLUSIONS
Platelet transfusion at the time of CABG is not associated with increased postoperative mortality, in-hospital myocardial infarction, stroke or need for repeat coronary revascularization.
Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark michhinr@rm.dk.
Michael
M
Kremke
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Malene Kærslund
MK
Hansen
Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.
Steffen
S
Christensen
Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.
Mariann
M
Tang
Departments of Cardiothoracic Surgery and Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark.
Jan Jesper
JJ
Andreasen
Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.
Carl-Johan
CJ
Jakobsen
D000368:Aged; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia; D017713:Platelet Transfusion / Q000009:adverse effects* / Q000401:mortality*; D057216:Propensity Score; D020521:Stroke; D013927:Thrombosis; D016896:Treatment Outcome
Coronary artery bypass; Myocardial ischaemia; Platelet transfusion; Stroke; Thrombosis