Effect of Preoperative Aspirin Use on Postoperative Bleeding and Perioperative Myocardial Infarction in Patients Undergoing Coronary Artery Bypass Surgery

Document Type : Original Article


Background- Continuation or discontinuation of aspirin use in the preoperative period for patients
scheduled for elective cardiac surgery has continued to be controversial. In this study, we tried
to evaluate clinical outcomes (mortality, postoperative bleeding and perioperative myocardial
infarction) in patients who underwent first elective coronary artery bypass grafting and
received aspirin during the preoperative period.
Methods- The study was a prospective, randomized and single-blinded clinical trial. Two-hundred
patients were included in the study and divided into two groups. One group received aspirin
80-160 mg and in the other group, aspirin was stopped at least for seven days before operation.
The primary end points of the study were in-hospital mortality rate and hemorrhage-related
complications (postoperative blood loss in the intensive care unit, reexploration for bleeding
and red blood cell and non-red blood cell transfusion requirements). The secondary end point
was perioperative myocardial infarction.
Results- There were no differences in patients’ characteristics among aspirin users and non-aspirin
users. We found a significant difference between postoperative blood loss (608±359.7 ml vs.
483±251.5 ml; P=0.005) and red blood cell product requirements (1.32±0.97 units packed
cells vs. 0.94±1.02 units packed cells; P=0.008) in the two groups. There was no significant
difference between the two groups regarding platelet requirements and the rate of in-hospital
mortality and reexploration for bleeding. Similarly, we found no significant difference in the
incidence of definite and probable perioperative myocardial infarction (P=0.24 and P=0.56,
respectively) and in-hospital mortality between the two groups.
Conclusion- Preoperative aspirin administration increased postoperative bleeding and red blood cell
requirements with no effect on mortality, reexploration rate and perioperative myocardial
infarction (Iranian Heart Journal 2008; 9 (2):18-22).


Mohammad Hassan Ghaffarinejad MD, Amir Farjam Fazelifar MD, Shahram Mohajer Shirvani MD,* Esmaeel Asdaghpoor MD, Farzad Fazeli MD and Freidoun Noohi MD*

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