Effect of clopidogrel premedication on clinical outcomes and bleeding complications in patients undergoing coronary artery bypass graft surgery
10.3760/cma.j.issn.1671.0282.2010.06.025
- VernacularTitle:氯吡格雷对冠状动脉旁路移植术临床与出血事件的影响
- Author:
Lili GENG
;
Shaopin NIE
;
Qiang LV
;
Junping KANG
;
Xinmin LIU
;
Rong HU
;
Jiahui WU
;
Xu LI
;
Changqi JIA
;
Xin DU
;
Jianzeng DONG
;
Xiaohui LIU
;
Changsheng MA
- Publication Type:Journal Article
- Keywords:
Coronary artery bypass graft surgery;
Clopidogrel;
Oral antiplatelet therapy;
Complication;
Bleeding complications;
Transfusions;
Major adverse cardiovascular and cerebral events;
Adverse drug reaction
- From:
Chinese Journal of Emergency Medicine
2010;19(6):643-646
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of clopidogrel premedication on in-hospital major adverse cardiovascular and cerebral events (MACCE) and bleeding outcomes before coronary artery bypass graft surgery (CABG). Method A total of 2021 patients who underwent CABG from July 2003 to September 2005 were divided into either clopidogrel ( n = 479) or no clopidogrel (1542) group before CABG. Patients with clopidogrel administration ( n = 479) were subdivided into < 5 d ( n = 154) ,5～7d(n = 183)and >7d(n = 142) group according to timing of clopidogrel withdrawal before surgery. In-hospital MACCE and perioperative bleeding outcomes were analyzed among groups. Results Patients who took clopidogrel before surgery had nonsignificantly rates of bleeding and in-hospital MACCE compared with those patients not administered clopidogrel. No differences were found about the incidence of total bleeding,minor bleeding,transfusions of red blood cells,fresh frozen plasma,whole blood and in-hosptial MACCE among three subgroups.The < 5 d group had higher incidence of major bleeding and more platelets transfusions than 5 ～ 7 d [47.8% vs. 31.9%,P < 0.017; (0.08 ±0.38) U vs. (0.00±0.00) U,P <0.017,respectively]and >7 d group [47.8% vs. 20.3%,P <0.017; (0.08±0.38) U vs. (0.00±0.00) U,P <0.017,respectively). However,there were no significant differences between 5 ～ 7 d and > 7 d group ( P > 0.05). Conclusions Gopidogrel administration before CABG does not increase the incidence of in-hospital MACCE events. However,the perioperative risk of bleeding will rise if the patients withhold clopidogrel less than five days before surgery.
