Effects of preoperative aspirin on cardiocerebral and renal complications in non-emergent cardiac surgery patients: a sub-group and cohort study.

Authors

Longhui Cao, Department of Anesthesiology, Jefferson Medical College, Thomas Jefferson University; Anesthesiology Department, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of ChinaFollow
Scott Silvestry, Division of Cardiothoracic Surgery, Jefferson Medical College, Thomas Jefferson UniversityFollow
Ning Zhao, Department of Psychiatry, University of Pennsylvania Health System
James Diehl, Division of Cardiothoracic Surgery, Jefferson Medical College, Thomas Jefferson UniversityFollow
Jianzhong Sun, Department of Anesthesiology, Jefferson Medical College, Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

2-2-2012

Comments

This article has been peer reviewed and is published in PLoS One 2012, 7(2): e30094. The published version is available at DOI: 10.1371/journal.pone.0030094. © Public Library of Science

Abstract

BACKGROUND AND OBJECTIVE: Postoperative cardiocerebral and renal complications are a major threat for patients undergoing cardiac surgery. This study was aimed to examine the effect of preoperative aspirin use on patients undergoing cardiac surgery.

METHODS: An observational cohort study was performed on consecutive patients (n = 1879) receiving cardiac surgery at this institution. The patients excluded from the study were those with preoperative anticoagulants, unknown aspirin use, or underwent emergent cardiac surgery. Outcome events included were 30-day mortality, renal failure, readmission and a composite outcome - major adverse cardiocerebral events (MACE) that include permanent or transient stroke, coma, perioperative myocardial infarction (MI), heart block and cardiac arrest.

RESULTS: Of all patients, 1145 patients met the inclusion criteria and were divided into two groups: those taking (n = 858) or not taking (n = 287) aspirin within 5 days preceding surgery. Patients with aspirin presented significantly more with history of hypertension, diabetes, peripheral arterial disease, previous MI, angina and older age. With propensity scores adjusted and multivariate logistic regression, however, this study showed that preoperative aspirin therapy (vs. no aspirin) significantly reduced the risk of MACE (8.4% vs. 12.5%, odds ratio [OR] 0.585, 95% CI 0.355-0.964, P = 0.035), postoperative renal failure (2.6% vs. 5.2%, OR 0.438, CI 0.203-0.945, P = 0.035) and dialysis required (0.8% vs. 3.1%, OR 0.230, CI 0.071-0.742, P = 0.014), but did not significantly reduce 30-day mortality (4.1% vs. 5.8%, OR 0.744, CI 0.376-1.472, P = 0.396) nor it increased readmissions in the patients undergoing cardiac surgery.

CONCLUSIONS: Preoperative aspirin therapy is associated with a significant decrease in the risk of MACE and renal failure and did not increase readmissions in patients undergoing non-emergent cardiac surgery.

Recommended Citation

Cao, Longhui; Silvestry, Scott; Zhao, Ning; Diehl, James; and Sun, Jianzhong, "Effects of preoperative aspirin on cardiocerebral and renal complications in non-emergent cardiac surgery patients: a sub-group and cohort study." (2012). Department of Anesthesiology Faculty Papers. Paper 16.
https://jdc.jefferson.edu/anfp/16

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

PubMed ID

22319558