Ayman Elbadawi1,2, Marwan Saad3, Ramez Nairooz4. 1. Department of Medicine, Rochester General Hospital, Rochester, NY, USA. 2. Department of Cardiovascular Medicine, Ain Shams University, Cairo, Egypt. 3. Division of Cardiovascular Medicine, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR, 72205,, USA. 4. Division of Cardiovascular Medicine, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR, 72205,, USA. ramez.nairooz@gmail.com.
Abstract
PURPOSE OF REVIEW: Aspirin use before coronary artery bypass graft (CABG) surgery has been a puzzling question for years. Controversy existed regarding the overall benefits vs. risk of pre-operative aspirin use and was translated to conflicting guidelines from major societies. RECENT FINDINGS: Observational studies have suggested a reduced mortality with pre-operative aspirin use. A meta-analysis of randomized controlled trials showed increased risk of post-operative bleeding with aspirin, with no associated increased mortality risk. A recent large randomized controlled trial did not find a significant difference in bleeding risk or post-operative mortality with pre-CABG aspirin use. The results of available studies showed a beneficial effect with pre-CABG aspirin use by decreasing thrombotic complications and perioperative myocardial infarction, with an associated adverse risk of bleeding that did not affect mortality rates. Given overall benefit-risk assessment, we are in favor of pre-operative aspirin use in CABG patients.
PURPOSE OF REVIEW: Aspirin use before coronary artery bypass graft (CABG) surgery has been a puzzling question for years. Controversy existed regarding the overall benefits vs. risk of pre-operative aspirin use and was translated to conflicting guidelines from major societies. RECENT FINDINGS: Observational studies have suggested a reduced mortality with pre-operative aspirin use. A meta-analysis of randomized controlled trials showed increased risk of post-operative bleeding with aspirin, with no associated increased mortality risk. A recent large randomized controlled trial did not find a significant difference in bleeding risk or post-operative mortality with pre-CABG aspirin use. The results of available studies showed a beneficial effect with pre-CABG aspirin use by decreasing thrombotic complications and perioperative myocardial infarction, with an associated adverse risk of bleeding that did not affect mortality rates. Given overall benefit-risk assessment, we are in favor of pre-operative aspirin use in CABG patients.
Authors: J S Wang; C Y Lin; W T Hung; M F O'Connor; R A Thisted; B K Lee; R B Karp; M W Yang Journal: Ann Thorac Surg Date: 1992-03 Impact factor: 4.330
Authors: S Goldman; J Copeland; T Moritz; W Henderson; K Zadina; T Ovitt; J Doherty; R Read; E Chesler; Y Sako Journal: Circulation Date: 1989-11 Impact factor: 29.690
Authors: Donald Lloyd-Jones; Robert J Adams; Todd M Brown; Mercedes Carnethon; Shifan Dai; Giovanni De Simone; T Bruce Ferguson; Earl Ford; Karen Furie; Cathleen Gillespie; Alan Go; Kurt Greenlund; Nancy Haase; Susan Hailpern; P Michael Ho; Virginia Howard; Brett Kissela; Steven Kittner; Daniel Lackland; Lynda Lisabeth; Ariane Marelli; Mary M McDermott; James Meigs; Dariush Mozaffarian; Michael Mussolino; Graham Nichol; Véronique L Roger; Wayne Rosamond; Ralph Sacco; Paul Sorlie; Randall Stafford; Thomas Thom; Sylvia Wasserthiel-Smoller; Nathan D Wong; Judith Wylie-Rosett Journal: Circulation Date: 2010-02-23 Impact factor: 29.690
Authors: Alexander Kulik; Marc Ruel; Hani Jneid; T Bruce Ferguson; Loren F Hiratzka; John S Ikonomidis; Francisco Lopez-Jimenez; Sheila M McNallan; Mahesh Patel; Véronique L Roger; Frank W Sellke; Domenic A Sica; Lani Zimmerman Journal: Circulation Date: 2015-02-09 Impact factor: 29.690
Authors: Longhui Cao; Nilas Young; Hong Liu; Scott Silvestry; Will Sun; Ning Zhao; James Diehl; Jianzhong Sun Journal: Ann Surg Date: 2012-02 Impact factor: 12.969
Authors: Patricia A Gum; Kandice Kottke-Marchant; Patricia A Welsh; Jennifer White; Eric J Topol Journal: J Am Coll Cardiol Date: 2003-03-19 Impact factor: 24.094