Preoperative aspirin use and its effect on adverse events in patients undergoing cardiac operations

Jiapeng Huang, Macarius Donneyong, Jaimin Trivedi, April Barnard, John Chaney, Adam Dotson, Sherri Raymer, Allen Cheng, Hong Liu, Mark S. Slaughter

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Background Preoperative aspirin use within 5 days of cardiac operations is controversial. Aspirin could reduce cardiovascular complications and yet might increase risk of bleeding. Recent reports showed conflicting results, and whether aspirin has variable effects for different cardiac surgical procedures is unclear. Methods A single-center retrospective cohort analysis was performed. After propensity score matching (PSM) for identified confounders, the relationship between preoperative aspirin use and 30-day all-cause mortality, postoperative renal failure, major adverse cardiocerebral events (MACE), blood transfusion, reoperation for bleeding, and postoperative infection were estimated with separate logistic regression models. Results Preoperative aspirin therapy was associated with a 49% (p = 0.04) increased risk of reoperation for bleeding among 868 matched pairs of patients undergoing valve operations. Among 725 matched patients undergoing coronary artery bypass grafting (CABG), preoperative aspirin therapy was not associated with a statistically significant higher risk of reoperation for bleeding. However, preoperative aspirin use, compared with nonuse, was not associated with risks of MACE, 30-day mortality, postoperative renal failure, blood transfusion, or postoperative infection in the entire cohort, in patients undergoing valve operations only, and in patients undergoing CABG only after PSM. Conclusions Preoperative aspirin use in all patients undergoing cardiac operations was not associated with risks of major cardiac, cerebral, or renal complications and infections and death; however, the risk of reoperation for bleeding was elevated among preoperative aspirin users compared with nonusers in a subpopulation of patients undergoing valve operations only.

Original languageEnglish (US)
Pages (from-to)1975-1981
Number of pages7
JournalAnnals of Thoracic Surgery
Volume99
Issue number6
DOIs
StatePublished - Jun 1 2015

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine
  • Medicine(all)

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    Huang, J., Donneyong, M., Trivedi, J., Barnard, A., Chaney, J., Dotson, A., Raymer, S., Cheng, A., Liu, H., & Slaughter, M. S. (2015). Preoperative aspirin use and its effect on adverse events in patients undergoing cardiac operations. Annals of Thoracic Surgery, 99(6), 1975-1981. https://doi.org/10.1016/j.athoracsur.2015.02.032