Preoperative aspirin therapy can benefit cardiac surgery patients
Aspirin taken within five days of cardiac surgery is associated with a significant decrease in the risk of major postoperative complications, including renal failure, a lengthy intensive care unit stay and even early death (30-day mortality), according to a study by researchers at Thomas Jefferson University and UC Davis Medical Center set to appear in the journal Annals of Surgery.
According to the study's authors, the findings are significant because despite remarkable progress in cardiac surgery, the number of major complications from cardiac surgery remains high.
"Therapies targeted to prevent or reduce major complications associated with cardiac surgery have been few and ineffective so far," said Jianzhong Sun, an anesthesiologist at Thomas Jefferson University and lead author of the study. "These complications are significant and costly both for the public health and the quality of patient life."
The study team evaluated the impact of preoperative aspirin on major outcomes in adults (total 4,256 consecutive patients) who had cardiac surgery -- mostly coronary artery bypass graft or valve surgery -- at Thomas Jefferson University Hospital or UC Davis Medical Center between 2001 and 2009. Among 2,868 patients who met the inclusion criteria, 1,923 took aspirin (about 81 to 325 mg daily) at least once within five days preceding their surgery versus 945 not taking aspirin (non-aspirin therapy).
The outcomes showed that preoperative aspirin therapy (vs. non-aspirin) is associated with a significant decrease in the risk for 30-day mortality, major adverse cardiocerebral events, postoperative renal failure and average time spent in the intensive care unit.
Beneficial effects of preoperative aspirin use found in the current study "are in line with our previous findings and findings from early postoperative aspirin studies," wrote Sun and colleagues in their paper.
"We know that aspirin can be lifesaving for patients who have experienced heart attacks," said Nilas Young, chief of cardiothoracic surgery at UC Davis and a study co-author. "Now we know that this simple intervention can do the same for patients who undergo certain coronary surgeries. This outcome could lead to new preoperative treatment standards in cardiac medicine."
The researchers acknowledge that bleeding remains a concern with preoperative aspirin therapy. However, they said, in the current era of cardiac surgery, the potential for bleeding may be avoided by using antifibrinolytic therapy, which prevents the breakdown of clotting factors in the blood, and/or a low dose of aspirin.
"Overall, the outcome benefits provided by preoperative aspirin therapy may override its possible risk of excess bleeding in patients undergoing cardiac surgery. Nonetheless, further studies are certainly needed to examine this potential side effect carefully," Sun and colleagues wrote.
Added Zvi Grunwald, chair of anesthesiology at Jefferson, "While we are excited that the study clearly showed that preoperative use of aspirin significantly reduced major complications and mortality in patients undergoing cardiac surgery, we do urge further study before recommending aspirin for cardiac surgery patients prior to surgery."
Journal reference:
Annals of Surgery
Provided by University of California - Davis Health System
-
Should patients undergoing surgery take Aspirin?
Oct 23, 2006 |
not rated yet |
0
-
New study shows patients with coronary artery disease
Aug 30, 2011 |
not rated yet |
0
-
Even low-dose aspirin may increase risk of GI bleeding
Sep 12, 2011 |
not rated yet |
0
-
Study examines link between beta-blocker use and risks of death and heart attack after surgery
Oct 20, 2008 |
not rated yet |
0
-
Stopping a daily aspirin routine increases heart attack risk
Jul 21, 2011 |
not rated yet |
0
-
Motion perception revisited: High Phi effect challenges established motion perception assumptions
Apr 23, 2013 |
3 / 5 (2) |
2
-
Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update)
Apr 02, 2013 |
4.5 / 5 (11) |
5
-
The visual system as economist: Neural resource allocation in visual adaptation
Mar 30, 2013 |
5 / 5 (2) |
9
-
Separate lives: Neuronal and organismal lifespans decoupled
Mar 27, 2013 |
4.9 / 5 (8) |
0
-
Sizing things up: The evolutionary neurobiology of scale invariance
Feb 28, 2013 |
4.8 / 5 (10) |
14
-
Calculus of Variation - Classical Mechanics
3 hours ago
-
Frictional Force Equation Doesn't Make Sense
3 hours ago
-
Calculating Steam Pressure in Closed Container
8 hours ago
-
Learning curve of Electromagnetism?
13 hours ago
-
thin glass in liquid
14 hours ago
-
How many joules expended for a push up?
17 hours ago
- More from Physics Forums - Classical Physics
More news stories
More than one-third of Texas women still receive unnecessary breast biopsy surgery
Many women in Texas who are found to have an abnormality on routine mammogram or discover a lump in one of their breasts end up having an old-fashioned surgical biopsy to find out whether the breast abnormality is malignant. ...
Surgery
May 17, 2013 |
not rated yet |
0
Majority of surgical residents object to regulated hours
(HealthDay)—About 65 percent of surgical residents report that they disapprove of the 2011 Accreditation Council for Graduate Medical Education (ACGME) Common Program requirements, which place restrictions ...
Surgery
May 16, 2013 |
not rated yet |
0
Tissue damage from metal-on-metal hip implants appears before pain symptoms appear
Metal-on-metal hip implants can cause inflammation of the joint lining (synovitis) long before symptoms appear, and magnetic resonance imaging (MRI) can be used to identify this inflammation, according to ...
Surgery
May 15, 2013 |
not rated yet |
0
Robotic transplant an option for obese kidney patients
Obese patients who received robotic kidney transplants had fewer wound complications than patients who received traditional "open" transplant surgery, according to surgeons at the University of Illinois Hospital ...
Surgery
May 15, 2013 |
not rated yet |
0
Indian medics conduct 'perfect' op on baby's swollen head (Update)
Doctors carried out life-saving surgery Wednesday on an Indian baby suffering from a rare disorder that caused her head to swell to nearly double its size, in a case that aroused sympathy worldwide.
Surgery
May 15, 2013 |
not rated yet |
0
Ketamine shows significant therapeutic benefit in people with treatment-resistant depression
Patients with treatment-resistant major depression saw dramatic improvement in their illness after treatment with ketamine, an anesthetic, according to the largest ketamine clinical trial to-date led by researchers from the ...
Consuming coffee linked to lower risk of detrimental liver disease, study finds
Regular consumption of coffee is associated with a reduced risk of primary sclerosing cholangitis (PSC), an autoimmune liver disease, Mayo Clinic research shows. The findings were being presented at the Digestive Disease ...
Research examines new methods for managing digestive health
Research presented at Digestive Disease Week (DDW) explores new methods for managing digestive health through diet and lifestyle.
New smartphone application improves colonoscopy preparation
The use of a smartphone application significantly improves patients' preparation for a colonoscopy, according to new research presented today at Digestive Disease Week (DDW). The preparation process, which begins days in ...
New research identifies practice changes to improve value and quality of GI procedures
There are significant cost and risk factors associated with two procedures commonly used to diagnose or treat gastrointestinal problems, according to research presented at Digestive Disease Week (DDW).
New research identifies risks, interventions for children's GI health
An increasing number of U.S. children are experiencing gastrointestinal issues that require interventions to resolve, according to research presented at Digestive Disease Week (DDW).