Preoperative aspirin use and outcomes in cardiac surgery patients

Longhui Cao, J Nilas Young, Hong Liu, Scott Silvestry, Will Sun, Ning Zhao, James Diehl, Jianzhong Sun

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Background: The effects of preoperative aspirin use on outcomes of cardiac surgery patients remain uncertain. This study was aimed to evaluate the effect of preoperative aspirin use on major outcomes in cardiac surgery patients. Methods: An observational cohort study was performed on consecutive patients (n = 4256) undergoing cardiac surgery in 2 tertiary hospitals. Of all patients, 2868 patients met the inclusion criteria and were divided into 2 groups: those taking (n = 1923) or not taking (n = 945) aspirin within 5 days preceding surgery. Results: Patients in the aspirin group presented significantly more with comorbidities including hypertension, diabetes, peripheral arterial disease, previous myocardial infarction, angina, cerebrovascular disease, older age, and male gender. With propensity scores adjusted and multivariate logistic regression, however, the results of this study showed that preoperative aspirin therapy (vs nonaspirin) significantly reduced the risk of 30-day mortality (3.5% vs 6.5%, OR: 0.611, 95% CI: 0.391-0.956, P = 0.031), postoperative renal failure (3.7% vs 7.1%, OR: 0.384, 95% CI: 0.254-0.579, P < 0.001), dialysis required (1.9% vs 3.6%, OR: 0.441, 95% CI: 0.254-0.579, P < 0.001), intensive care unit stay (mean 107.2 vs 136.1 h, P < 0.001) and a composite outcome-major adverse cardiocerebral events (8.7% vs 10.8%, OR: 0.662, 95% CI:: 0.482-0.909, P = 0.011) in the patients undergoing cardiac surgery. However, readmissions did not show a significant difference between the 2 groups (14.5% vs 12.8%, P = 0.944). Conclusions: Preoperative aspirin therapy is associated with a significant decrease in the risk of major cardiocerebral complications, renal failure, intensive care unit stay and 30-day mortality but does not increase the risk of readmissions in patients undergoing cardiac surgery.

Original languageEnglish (US)
Pages (from-to)399-404
Number of pages6
JournalAnnals of Surgery
Volume255
Issue number2
DOIs
StatePublished - Feb 2012

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Aspirin
Thoracic Surgery
Renal Insufficiency
Intensive Care Units
Cerebrovascular Disorders
Patient Readmission
Propensity Score
Mortality
Peripheral Arterial Disease
Ambulatory Surgical Procedures
Tertiary Care Centers
Observational Studies
Comorbidity
Dialysis
Cohort Studies
Logistic Models
Myocardial Infarction
Hypertension
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Preoperative aspirin use and outcomes in cardiac surgery patients. / Cao, Longhui; Young, J Nilas; Liu, Hong; Silvestry, Scott; Sun, Will; Zhao, Ning; Diehl, James; Sun, Jianzhong.

In: Annals of Surgery, Vol. 255, No. 2, 02.2012, p. 399-404.

Research output: Contribution to journalArticle

Cao, L, Young, JN, Liu, H, Silvestry, S, Sun, W, Zhao, N, Diehl, J & Sun, J 2012, 'Preoperative aspirin use and outcomes in cardiac surgery patients', Annals of Surgery, vol. 255, no. 2, pp. 399-404. https://doi.org/10.1097/SLA.0b013e318234313b
Cao, Longhui ; Young, J Nilas ; Liu, Hong ; Silvestry, Scott ; Sun, Will ; Zhao, Ning ; Diehl, James ; Sun, Jianzhong. / Preoperative aspirin use and outcomes in cardiac surgery patients. In: Annals of Surgery. 2012 ; Vol. 255, No. 2. pp. 399-404.
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AU - Silvestry, Scott

AU - Sun, Will

AU - Zhao, Ning

AU - Diehl, James

AU - Sun, Jianzhong

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N2 - Background: The effects of preoperative aspirin use on outcomes of cardiac surgery patients remain uncertain. This study was aimed to evaluate the effect of preoperative aspirin use on major outcomes in cardiac surgery patients. Methods: An observational cohort study was performed on consecutive patients (n = 4256) undergoing cardiac surgery in 2 tertiary hospitals. Of all patients, 2868 patients met the inclusion criteria and were divided into 2 groups: those taking (n = 1923) or not taking (n = 945) aspirin within 5 days preceding surgery. Results: Patients in the aspirin group presented significantly more with comorbidities including hypertension, diabetes, peripheral arterial disease, previous myocardial infarction, angina, cerebrovascular disease, older age, and male gender. With propensity scores adjusted and multivariate logistic regression, however, the results of this study showed that preoperative aspirin therapy (vs nonaspirin) significantly reduced the risk of 30-day mortality (3.5% vs 6.5%, OR: 0.611, 95% CI: 0.391-0.956, P = 0.031), postoperative renal failure (3.7% vs 7.1%, OR: 0.384, 95% CI: 0.254-0.579, P < 0.001), dialysis required (1.9% vs 3.6%, OR: 0.441, 95% CI: 0.254-0.579, P < 0.001), intensive care unit stay (mean 107.2 vs 136.1 h, P < 0.001) and a composite outcome-major adverse cardiocerebral events (8.7% vs 10.8%, OR: 0.662, 95% CI:: 0.482-0.909, P = 0.011) in the patients undergoing cardiac surgery. However, readmissions did not show a significant difference between the 2 groups (14.5% vs 12.8%, P = 0.944). Conclusions: Preoperative aspirin therapy is associated with a significant decrease in the risk of major cardiocerebral complications, renal failure, intensive care unit stay and 30-day mortality but does not increase the risk of readmissions in patients undergoing cardiac surgery.

AB - Background: The effects of preoperative aspirin use on outcomes of cardiac surgery patients remain uncertain. This study was aimed to evaluate the effect of preoperative aspirin use on major outcomes in cardiac surgery patients. Methods: An observational cohort study was performed on consecutive patients (n = 4256) undergoing cardiac surgery in 2 tertiary hospitals. Of all patients, 2868 patients met the inclusion criteria and were divided into 2 groups: those taking (n = 1923) or not taking (n = 945) aspirin within 5 days preceding surgery. Results: Patients in the aspirin group presented significantly more with comorbidities including hypertension, diabetes, peripheral arterial disease, previous myocardial infarction, angina, cerebrovascular disease, older age, and male gender. With propensity scores adjusted and multivariate logistic regression, however, the results of this study showed that preoperative aspirin therapy (vs nonaspirin) significantly reduced the risk of 30-day mortality (3.5% vs 6.5%, OR: 0.611, 95% CI: 0.391-0.956, P = 0.031), postoperative renal failure (3.7% vs 7.1%, OR: 0.384, 95% CI: 0.254-0.579, P < 0.001), dialysis required (1.9% vs 3.6%, OR: 0.441, 95% CI: 0.254-0.579, P < 0.001), intensive care unit stay (mean 107.2 vs 136.1 h, P < 0.001) and a composite outcome-major adverse cardiocerebral events (8.7% vs 10.8%, OR: 0.662, 95% CI:: 0.482-0.909, P = 0.011) in the patients undergoing cardiac surgery. However, readmissions did not show a significant difference between the 2 groups (14.5% vs 12.8%, P = 0.944). Conclusions: Preoperative aspirin therapy is associated with a significant decrease in the risk of major cardiocerebral complications, renal failure, intensive care unit stay and 30-day mortality but does not increase the risk of readmissions in patients undergoing cardiac surgery.

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