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Clopidogrel and bleeding after coronary artery bypass graft surgery.
Ann Thorac Surg. 2005 Sep; 80(3):928-33.AT

Abstract

BACKGROUND

There is evidence that clopidogrel (with or without aspirin) confers superior outcomes in patients with coronary artery disease. The purpose of this study is to review the effect of preoperative clopidogrel administration on clinical outcome, bleeding complications and resource utilization after coronary artery bypass graft surgery.

METHODS

Patient data were prospectively collected from 919 patients who had isolated coronary surgery during the period 2000 to 2003. Outcome comparisons were studied, firstly between patients who received preoperative clopidogrel with those who did not, and secondly between patients on clopidogrel only, aspirin only, both or neither medications.

RESULTS

Twenty-four patients (2.6%) were on clopidogrel only, 598 (65.1%) were on aspirin only, 61 (6.6%) were on both, and 236 (25.7%) were on neither. Clopidogrel (n = 85) versus no clopidogrel (n = 834): there were no significant differences in the off-pump patients. In the on-pump patients, the clopidogrel group had significantly increased bleeding (p = 0.02), blood transfused (p = 0.01), intensive care (p = 0.03), and hospital stays (p = 0.03). There were no significant differences in surgical reexploration, perioperative myocardial infarction, intraoperative balloon pump use, inotropic support or 30-day mortality. Clopidogrel versus aspirin versus both versus neither: patients on both clopidogrel and aspirin had significantly more postoperative bleeding than patients on aspirin alone or on neither medication.

CONCLUSIONS

The preoperative use of clopidogrel in patients undergoing coronary artery bypass graft surgery showed limited clinical benefits; however, its use significantly increased the risk of bleeding, blood transfusion, and resource utilization.

Authors+Show Affiliations

Flinders Medical Centre and Flinders University, Adelaide, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

16122457

Citation

Leong, Jee-Yoong, et al. "Clopidogrel and Bleeding After Coronary Artery Bypass Graft Surgery." The Annals of Thoracic Surgery, vol. 80, no. 3, 2005, pp. 928-33.
Leong JY, Baker RA, Shah PJ, et al. Clopidogrel and bleeding after coronary artery bypass graft surgery. Ann Thorac Surg. 2005;80(3):928-33.
Leong, J. Y., Baker, R. A., Shah, P. J., Cherian, V. K., & Knight, J. L. (2005). Clopidogrel and bleeding after coronary artery bypass graft surgery. The Annals of Thoracic Surgery, 80(3), 928-33.
Leong JY, et al. Clopidogrel and Bleeding After Coronary Artery Bypass Graft Surgery. Ann Thorac Surg. 2005;80(3):928-33. PubMed PMID: 16122457.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clopidogrel and bleeding after coronary artery bypass graft surgery. AU - Leong,Jee-Yoong, AU - Baker,Robert A, AU - Shah,Pallav J, AU - Cherian,Vijit K, AU - Knight,John L, PY - 2004/07/15/received PY - 2005/03/13/revised PY - 2005/03/18/accepted PY - 2005/8/27/pubmed PY - 2006/9/19/medline PY - 2005/8/27/entrez SP - 928 EP - 33 JF - The Annals of thoracic surgery JO - Ann Thorac Surg VL - 80 IS - 3 N2 - BACKGROUND: There is evidence that clopidogrel (with or without aspirin) confers superior outcomes in patients with coronary artery disease. The purpose of this study is to review the effect of preoperative clopidogrel administration on clinical outcome, bleeding complications and resource utilization after coronary artery bypass graft surgery. METHODS: Patient data were prospectively collected from 919 patients who had isolated coronary surgery during the period 2000 to 2003. Outcome comparisons were studied, firstly between patients who received preoperative clopidogrel with those who did not, and secondly between patients on clopidogrel only, aspirin only, both or neither medications. RESULTS: Twenty-four patients (2.6%) were on clopidogrel only, 598 (65.1%) were on aspirin only, 61 (6.6%) were on both, and 236 (25.7%) were on neither. Clopidogrel (n = 85) versus no clopidogrel (n = 834): there were no significant differences in the off-pump patients. In the on-pump patients, the clopidogrel group had significantly increased bleeding (p = 0.02), blood transfused (p = 0.01), intensive care (p = 0.03), and hospital stays (p = 0.03). There were no significant differences in surgical reexploration, perioperative myocardial infarction, intraoperative balloon pump use, inotropic support or 30-day mortality. Clopidogrel versus aspirin versus both versus neither: patients on both clopidogrel and aspirin had significantly more postoperative bleeding than patients on aspirin alone or on neither medication. CONCLUSIONS: The preoperative use of clopidogrel in patients undergoing coronary artery bypass graft surgery showed limited clinical benefits; however, its use significantly increased the risk of bleeding, blood transfusion, and resource utilization. SN - 1552-6259 UR - https://www.unboundmedicine.com/medline/citation/16122457/Clopidogrel_and_bleeding_after_coronary_artery_bypass_graft_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-4975(05)00534-5 DB - PRIME DP - Unbound Medicine ER -