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Clopidogrel does not increase bleeding and allogenic blood transfusion in coronary artery surgery.
Eur J Cardiothorac Surg. 2004 Mar; 25(3):419-23.EJ

Abstract

OBJECTIVES

Platelet dysfunction is one of the major reasons of postoperative bleeding following coronary artery surgery. The aim of this study was to evaluate the effects of clopidogrel; a specific and potent irreversible inhibitor of platelet aggregation; on bleeding and use of blood and blood products after coronary artery bypass surgery (CABG).

METHODS

Preoperative patient characteristics and perioperative and postoperative data were collected prospectively in 1628 consecutive patients undergoing isolated CABG performed by the same surgical and anesthesia team. Of these, 48 were receiving clopidogrel preoperatively. Of the 1628 patients, 1456 underwent elective and 172 (10.6%) underwent non-elective operation. Thirty-six (2.5%) of the elective patients and 12 (7%) of the non-elective patients were using clopidogrel, preoperatively. Baseline characteristics, chest tube output, and the need for reexploration or for blood and blood product transfusion of clopidogrel recipients and non-recipients were compared. The clopidogrel group had higher prothrombin time level (12.6+/-1.6; 11.5+/-1.7 s, (P=0.013), however comparable aPTT level (32.6+/-4.5 vs. 31.4+/-4.5 s), and platelet count (275,000+/-98,000 vs. 280,000+/-72,000 dl(-1)).

RESULTS

The need for reexploration or for blood and blood product transfusion, chest tube output, ICU length of stay (20.1+/-2.9 vs. 21.9+/-13.5 h; P=NS), and hospital length of stay (5.5+/-1.7 vs. 5.4+/-2.1 days; P=NS) were similar in clopidogrel recipients and non-recipients, respectively. Further analysis demonstrated no significant difference in use of homologous blood or fresh frozen plasma, amount of postoperative bleeding and reoperation rates for bleeding as well as length of intensive care unit and hospital stay between the clopidogrel and the control groups both in elective and non-elective patients.

CONCLUSIONS

The results of this study suggest that preoperative use of clopidogrel is not associated with increased bleeding and need for surgical exploration as well as risk of blood and blood product transfusion after CABG.

Authors+Show Affiliations

Department of Cardiovascular Surgery, Acibadem Hospital, Tekin Sokak, No. 8, 34718 Acibadem, Istanbul, Turkey. hasankarabulut@turk.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

15019671

Citation

Karabulut, Hasan, et al. "Clopidogrel Does Not Increase Bleeding and Allogenic Blood Transfusion in Coronary Artery Surgery." European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, vol. 25, no. 3, 2004, pp. 419-23.
Karabulut H, Toraman F, Evrenkaya S, et al. Clopidogrel does not increase bleeding and allogenic blood transfusion in coronary artery surgery. Eur J Cardiothorac Surg. 2004;25(3):419-23.
Karabulut, H., Toraman, F., Evrenkaya, S., Goksel, O., Tarcan, S., & Alhan, C. (2004). Clopidogrel does not increase bleeding and allogenic blood transfusion in coronary artery surgery. European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, 25(3), 419-23.
Karabulut H, et al. Clopidogrel Does Not Increase Bleeding and Allogenic Blood Transfusion in Coronary Artery Surgery. Eur J Cardiothorac Surg. 2004;25(3):419-23. PubMed PMID: 15019671.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clopidogrel does not increase bleeding and allogenic blood transfusion in coronary artery surgery. AU - Karabulut,Hasan, AU - Toraman,Fevzi, AU - Evrenkaya,Serdar, AU - Goksel,Onur, AU - Tarcan,Sumer, AU - Alhan,Cem, PY - 2003/08/17/received PY - 2003/11/20/revised PY - 2003/11/27/accepted PY - 2004/3/17/pubmed PY - 2004/4/16/medline PY - 2004/3/17/entrez SP - 419 EP - 23 JF - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JO - Eur J Cardiothorac Surg VL - 25 IS - 3 N2 - OBJECTIVES: Platelet dysfunction is one of the major reasons of postoperative bleeding following coronary artery surgery. The aim of this study was to evaluate the effects of clopidogrel; a specific and potent irreversible inhibitor of platelet aggregation; on bleeding and use of blood and blood products after coronary artery bypass surgery (CABG). METHODS: Preoperative patient characteristics and perioperative and postoperative data were collected prospectively in 1628 consecutive patients undergoing isolated CABG performed by the same surgical and anesthesia team. Of these, 48 were receiving clopidogrel preoperatively. Of the 1628 patients, 1456 underwent elective and 172 (10.6%) underwent non-elective operation. Thirty-six (2.5%) of the elective patients and 12 (7%) of the non-elective patients were using clopidogrel, preoperatively. Baseline characteristics, chest tube output, and the need for reexploration or for blood and blood product transfusion of clopidogrel recipients and non-recipients were compared. The clopidogrel group had higher prothrombin time level (12.6+/-1.6; 11.5+/-1.7 s, (P=0.013), however comparable aPTT level (32.6+/-4.5 vs. 31.4+/-4.5 s), and platelet count (275,000+/-98,000 vs. 280,000+/-72,000 dl(-1)). RESULTS: The need for reexploration or for blood and blood product transfusion, chest tube output, ICU length of stay (20.1+/-2.9 vs. 21.9+/-13.5 h; P=NS), and hospital length of stay (5.5+/-1.7 vs. 5.4+/-2.1 days; P=NS) were similar in clopidogrel recipients and non-recipients, respectively. Further analysis demonstrated no significant difference in use of homologous blood or fresh frozen plasma, amount of postoperative bleeding and reoperation rates for bleeding as well as length of intensive care unit and hospital stay between the clopidogrel and the control groups both in elective and non-elective patients. CONCLUSIONS: The results of this study suggest that preoperative use of clopidogrel is not associated with increased bleeding and need for surgical exploration as well as risk of blood and blood product transfusion after CABG. SN - 1010-7940 UR - https://www.unboundmedicine.com/medline/citation/15019671/Clopidogrel_does_not_increase_bleeding_and_allogenic_blood_transfusion_in_coronary_artery_surgery_ L2 - https://academic.oup.com/ejcts/article-lookup/doi/10.1016/j.ejcts.2003.11.037 DB - PRIME DP - Unbound Medicine ER -