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To continue or discontinue aspirin in the perioperative period: a randomized, controlled clinical trial
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- Oscarsson Tibblin, Anna (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Anestesiologi med intensivvård,Hälsouniversitetet,Anestesi- och intensivvårdskliniken VIN
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- Gupta, Anil (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Anestesiologi med intensivvård,Hälsouniversitetet,Anestesi- och operationkliniken US
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- Fredrikson, Mats (författare)
- Linköpings universitet,Yrkes- och miljömedicin,Hälsouniversitetet
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- (creator_code:org_t)
- Elsevier BV, 2010
- 2010
- Engelska.
- Ingår i: British Journal of Anaesthesia. - : Elsevier BV. - 0007-0912 .- 1471-6771. ; 104:3, s. 305-312
- Tidskriftsartikel (refereegranskat)
Abstract
Ämnesord
Stäng
- Background: Major adverse cardiac events (MACEs) are a common cause of deathafter non-cardiac surgery. Despite evidence for the benefitof aspirin for secondary prevention, it is often discontinuedin the perioperative period due to the risk of bleeding. Methods: We conducted a randomized, double-blind, placebo-controlledtrial in order to compare the effect of low-dose aspirin withthat of placebo on myocardial damage, cardiovascular, and bleedingcomplications in high-risk patients undergoing non-cardiac surgery.Aspirin (75 mg) or placebo was given 7 days before surgery andcontinued until the third postoperative day. Patients were followedup for 30 days after surgery. Results: A total of 220 patients were enrolled, 109 patients receivedaspirin and 111 received placebo. Four patients (3.7%) in theaspirin group and 10 patients (9.0%) in the placebo group hadelevated troponin T levels in the postoperative period (P=0.10).Twelve patients (5.4%) had an MACE during the first 30 postoperativedays. Two of these patients (1.8%) were in the aspirin groupand 10 patients (9.0%) were in the placebo group (P=0.02). Treatmentwith aspirin resulted in a 7.2% absolute risk reduction [95%confidence interval (CI), 1.3–13%] for postoperative MACE.The relative risk reduction was 80% (95% CI, 9.2–95%).Numbers needed to treat were 14 (95% CI, 7.6–78). No significantdifferences in bleeding complications were seen between thetwo groups. Conclusions: In high-risk patients undergoing non-cardiac surgery, perioperativeaspirin reduced the risk of MACE without increasing bleedingcomplications. However, the study was not powered to evaluatebleeding complications.
Nyckelord
- analgesics non-opioid
- aspirin; complications
- haemorrhage; heart
- ischaemia; surgery
- non-cardiac
- MEDICINE
- MEDICIN
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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- British Journal of Anaesthesia (Sök värdpublikationen i LIBRIS)
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