- Taking aspirin before and after coronary artery bypass graft (CABG) surgery may reduce risk of death.
- Aspirin prevents blood from clotting.
- Elevated risk of blood clots can occur after cardiac surgery.
Taking aspirin before and after surgery is associated with an 18 percent to 34 percent reduced mortality risk after 4 years. The study is by Professor Jianzhong Sun, Director of Clinical Outcomes Research at the Department of Anesthesiology, Thomas Jefferson University and Hospitals, Philadelphia, USA, and colleagues.
CABG surgery is used to restore normal blood flow to an obstructed artery in the heart. Cardiac surgery frequently provokes a state of extreme and complex stress with a greatly elevated risk of blood clots and an increased predisposition to long-term vascular disease and mortality. It is hoped that perioperative aspirin (taken before and after the operation) may reduce these adverse effects.
Preoperative and postoperative uses of aspirin are defined as within 5 days preceding surgery and continuously on discharge respectively. The discharge prescription of aspirin often is indicated for patients with CABG and it should be continued indefinitely, except for patients with contraindications. The reported rates of patient aspirin adherence for cardiovascular protection are high, range from 72 percent to 92 percent in the literature.
The team looked at the medical records of 9,584 patients who received cardiac surgery in three hospitals, selecting the 4,132 individuals who underwent CABG. This selection was then further divided into four groups; in which patients had one of preoperative or postoperative aspirin, both, or neither.
Among the studied patients, 76.5 percent received preoperative aspirin, 23.5 percent did not, 92.3 percent received postoperative aspirin, and just 7.7 percent did not. Patients taking preoperative aspirin were significantly more likely to have other risk factors including smoking, diabetes, peripheral vascular disease, angina, high blood pressure, and previous heart attacks.
For patients taking preoperative aspirin, 4-year mortality was 14.8 percent versus 18.1 percent for those not taking preoperative aspirin, a statistically significant mortality reduction of 18 percent. For postoperative aspirin, there was a larger mortality reduction: those taking aspirin had a 4-year mortality rate of 10.7 percent, compared with 16.2 percent in the non-aspirin patients -- a statistically significant mortality reduction of 34 percent.
Professor Sun says: "Our study showed that aspirin was associated with similar effectiveness to other proven medical treatments in patients with cardiovascular disease, such as statins and ACE inhibitors."
He concludes: "Among patients undergoing CABG, perioperative uses of aspirin were associated with significant reduction in 30-day mortality and improvement in long-term survival, without significant increased postoperative bleeding complications. We believe that all patients undergoing CABG should take aspirin before and after the procedure, except those for whom aspirin is contraindicated."
- Study Shows Taking Aspirin Before or After Coronaryartery Bypass Graft Is Associated with a Lower Risk of Death - ( https://www.eurekalert.org/pub_releases/2018-06/eso-sst053118.php)