Bleeding-associated outcomes with preoperative clopidogrel use in on- and off-pump coronary artery bypass.

Journal of Thrombosis and Thrombolysis
Jeffrey S BergerRichard C Becker

Abstract

Clopidogrel use prior to coronary artery bypass graft surgery in patients presenting with acute coronary syndromes is associated with a greater incidence of procedural related morbidity. We studied the impact of clopidogrel pre-treatment in patients undergoing off-pump versus on-pump coronary revascularization. This report describes a post hoc analysis of 431 on-pump and 165 off-pump cases from a retrospective multicenter study of the impact of preoperative (within 5 days) clopidogrel use on bleeding related outcomes and surgical reintervention. Logistic regression was used to analyze the outcomes with respect to surgery type and clopidogrel exposure while using a propensity score risk adjustment for off-pump surgery. The hospital length of stay (9.3 ± 5.4 days vs. 8.9 ± 5.3 days, p = 0.35), major bleeding (21% vs. 20%, p = 0.74) and reoperation (3.7% vs. 4.8%, p = 0.53) were similar between on-pump and off-pump, respectively. In both surgical cohorts, recent clopidogrel use was associated with a greater incidence of major bleeding, reoperation, and transfusion. After multivariable adjustment, the odds ratio of major bleeding (1.76, 95% confidence interval 0.88-3.52 on-pump; 2.37, 95% confidence interval 1.06-5.30 off-pump) and...Continue Reading

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Citations

Nov 26, 2013·Journal of Cardiovascular Translational Research·Davide Capodanno, Corrado Tamburino
Dec 21, 2014·Seminars in Thoracic and Cardiovascular Surgery·Victor A Ferraris, Michael D Bolanos
May 24, 2016·The Journal of Thoracic and Cardiovascular Surgery·Felix BalzerMichael Sander
May 30, 2014·Circulation Journal : Official Journal of the Japanese Circulation Society·Davide Capodanno

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