Aspirin before non-cardiac surgery is ineffective and often harmful

Researchers Debbie Dumerton-Shore, Joel Parlow, Jessica McCourt and Rene Allard are part of a ground breaking study investigating the use of Aspirin to protect the heart after surgery. Credit: Matthew Manor

(Medical Xpress)—Queen's University and Kingston General Hospital researchers are part of a groundbreaking international study that has shown that starting – or continuing – to take Aspirin before non-cardiac surgery as a way to protect the heart after surgery is ineffective and, in some cases, harmful.

Because surgery puts at increased risk of heart attack, doctors often continue to administer low doses of Aspirin before and after non-cardiac procedures. But new data from the Peri-Operative Ischemic Evaluation Study (POISE-2), published last week in the New England Journal of Medicine, shows that administering Aspirin provided no benefit in reducing the risk of heart-related complications after surgery.

"In fact, Aspirin was shown to increase the risk of serious bleeding after , in some cases," says Joel Parlow, Head of Anesthesiology and Perioperative Medicine at both Queen's and KGH and the hospital's POISE-2 Site Principal Investigator. "This is important news for the medical community and for patients with risk factors for heart disease who are set to undergo ."

With over 10,000 patients from 23 countries and 135 centres, the study is the largest clinical trial to evaluate major cardiovascular complications in non-cardiac surgeries. More than 400 patients were enlisted from KGH, making it the fourth-largest recruiting site in the world, after Hamilton Health Sciences Centre and The Cleveland Clinic.

The POISE-2 study was designed and led by Principal Investigator P. J. Devereaux (McMaster University's Population Health Research Institute).

"KGH was able to be a vital contributor to this important study due to the dedication of our excellent research nurses Debbie Dumerton-Shore, Jessica McCourt and Beth Orr, and my co-investigator René Allard. Our research team works side-by-side with patients, surgeons, nurses and with the input of the other members of the Department of Anesthesiology and Perioperative Medicine," says Dr. Parlow.

More information: The study is available online: www.nejm.org/doi/full/10.1056/NEJMoa1401105

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