The use of preoperative aspirin in cardiac surgery: A systematic review and meta-analysis

Autor:	Sleiman Sebastian Aboul-Hassan, Bartosz Kryszkowski, Tomasz Stankowski, Jakub Marczak, Romuald Cichoń, Ryszard Stanislawski, Marcin Nawotka, Maciej Peksa
Rok vydání:	2017
Předmět:	Reoperation Pulmonary and Respiratory Medicine medicine.medical_specialty Postoperative Hemorrhage 030204 cardiovascular system & hematology law.invention Coronary artery disease 03 medical and health sciences Postoperative Complications 0302 clinical medicine Randomized controlled trial law Preoperative Care Odds Ratio Humans Medicine Myocardial infarction Cardiac Surgical Procedures Aspirin Models Statistical business.industry Incidence (epidemiology) Acute kidney injury Perioperative medicine.disease Cardiac surgery Treatment Outcome 030228 respiratory system Anesthesia Surgery Erythrocyte Transfusion Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors medicine.drug
Zdroj:	Journal of Cardiac Surgery. 32:758-774
ISSN:	0886-0440
Popis:	Background Despite the fact that aspirin is of benefit to patients following coronary artery bypass grafting (CABG), continuation or administration of preoperative aspirin before CABG or any cardiac surgical procedure remains controversial. Therefore, we performed a systematic review and meta-analysis to assess the influence of preoperative aspirin administration on patients undergoing cardiac surgery. Materials and methods Medline database was searched using OVID SP interface. Similar searches were performed separately in EMBASE, PubMed, and Cochrane Central Registry of Controlled Trials. Results Twelve randomized controlled trials and 28 observational studies met our inclusion criteria and were included in the meta-analysis. The use of preoperative aspirin in patients undergoing CABG at any dose is associated with reduced early mortality as well as a reduced incidence of postoperative acute kidney injury (AKI). Low-dose aspirin (≤160 mg/d) is associated with a decreased incidence of perioperative myocardial infarction (MI). Administration of preoperative aspirin at any dose in patients undergoing cardiac surgery increases postoperative bleeding. Despite this effect of preoperative aspirin, it did not increase the rates of surgical re-exploration due to excessive postoperative bleeding nor did it increase the rates of packed red blood cell transfusions (PRBC) when preoperative low-dose aspirin (≤160 mg/d) was administered. Conclusions Preoperative aspirin increases the risk for postoperative bleeding. However, this did not result in an increased need for chest re-exploration and did not increase the rates of PRBC transfusion when preoperative low-dose (≤160 mg/d) aspirin was administered. Aspirin at any dose is associated with decreased mortality and AKI and low-dose aspirin (≤160 mg/d) decreases the incidence of perioperative MI.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0ec22dbefe3b767fd545c5af051e82b8 https://doi.org/10.1111/jocs.13250 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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