Taking aspirin before and after a coronary artery bypass graft (CABG) surgery associated with reduced mortality
Aspirin – the commonly used blood thinner – can improve outcomes of CABG surgery.
New research presented at this year’s Euroanaesthesia congress in Copenhagen, Denmark shows that in patients undergoing a coronary artery bypass graft (CABG) surgery, taking aspirin before and after surgery is associated with an 18% to 34% reduced mortality risk after 4 years.
The study is by Professor Jianzhong Sun, Director of Clinical Outcomes Research at the Department of Anesthesiology, Thomas Jefferson University and Hospitals, Philadelphia.
CABG surgery is used to restore normal blood flow to an obstructed artery in the heart. Cardiac surgery frequently provokes a state of extreme and complex stress with a greatly elevated risk of blood clots. It is also associated with increased predisposition to long-term vascular disease and mortality. The study theorised that aspirin (taken before and after the operation) may reduce these adverse effects.
For patients taking preoperative aspirin, 4-year mortality was 14.8% versus 18.1% for those not taking preoperative aspirin.
Preoperative and postoperative uses of aspirin are defined as within 5 days preceding surgery and continuously on discharge respectively.
The reported rates of patient aspirin adherence for cardiovascular protection are high, range from 72% to 92% in the literature.
Most previous studies on aspirin’s effects in cardiac surgery were limited by the length of follow-up. And little is known about perioperative aspirin’s effect on the long-term survival in patients undergoing CABG surgery. This study from institutions in the US and China studied the effects of perioperative aspirin on long-term mortality in patients undergoing coronary artery bypass graft (CABG).
Among the studied patients, 76.5% received preoperative aspirin, 23.5% did not, 92.3% received postoperative aspirin, and just 7.7% did not. Patients taking preoperative aspirin were significantly more likely to have other risk factors including smoking, diabetes, peripheral vascular disease, angina, high blood pressure, and previous heart attacks.
For patients taking preoperative aspirin, 4-year mortality was 14.8% versus 18.1% for those not taking preoperative aspirin. This was a statistically significant mortality reduction of 18%.
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