Objective: To analyze the effects of preoperative uses of aspirin and clopidogrel on perioperative blood loss and blood transfusion requirements and complication in patients undergoing off-pump coronary artery bypass graft (CABG).
Methods: At our hospital from October 2011 to October 2012, a total of 480 patients underwent off-pump CABG performed by the same surgical team. Among them, 198 patients continued aspirin (discontinued clopidogrel at least 5 days) through operation (aspirin group, 1), 53 had aspirin and clopidogrel until 3 days before surgery (aspirin and clopidogrel group, 2) and 229 discontinued antiplatelet therapy 5 more days before surgery (control group, 3).
Results: No significant difference of basic clinical characteristics existed among three groups (P > 0.05). Group 2 was associated with a greater volume of chest tube drainage than other groups (827 ± 216 vs 416 ± 135 vs 265 ± 85 ml, P < 0.05). There was no significant difference between groups 1 and 3, even though chest tube drainage volume of group 1 was greater (827 ± 216vs 265 ± 85 ml, P > 0.05). There was no instance of stroke, myocardial infarction or post-operative mortality.
Conclusion: Preoperative clopidogrel exposure within 5 days of surgery increases perioperative blood loss. And the pre-operative use of aspirin results in no difference in postoperative perioperative blood loss and cardiovascular outcomes.