The impact of preoperative dual antiplatelet therapy on early outcome of acute type A aortic dissection patients undergoing aortic surgery
10.3760/cma.j.issn.1001-4497.2019.12.006
- VernacularTitle: 术前双重抗血小板对急性A型主动脉夹层术后早期的影响
- Author:
Fucheng XIAO
1
;
Yipeng GE
1
;
Chengnan LI
1
;
Zhiyu QIAO
1
;
Haiou HU
1
;
Lizhong SUN
1
;
Junming ZHU
1
Author Information
1. Department of Cardiovascular Surgery, Beijing Aortic Disease Centre, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China
- Publication Type:Journal Article
- Keywords:
Aortic dissection;
Aortic disease;
Antiplatelet therapy
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2019;35(12):735-738
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the impact of preoperative dual antiplatelet therapy on early outcome of acute type A aortic dissection(ATAAD) patients undergoing aortic surgery.
Methods:From December 2015 to November 2017, 45 consecutive patients with ingestion of aspirin and clopidogrel underwent aortic repair surgery at our center. 37 out of 45 patients(83%) were propensity-matched with 74 control ATAAD patients without antiplatelet therapy undergoing aortic surgery in 1∶2 fashion. Thereby, bleeding-related outcome(death, reoperation for bleeding, postoperative blood loss within 12 h ≥2 000 ml and usage of rFⅦa) and blood transfusion requirement were compared.
Results:Bleeding-related outcome occurred in 14(18.9%) and 9(24.3%) patients in control and antiplatelet group respectively(P=0.51). Postoperative blood loss within 12 hours was 490 ml in control group, compared to 500 ml in the antiplatelet group(P=0.85). There were no significant differences among the two groups in transfusion requirements of red blood cells, platelets and fresh frozen plasma. Multivariate regression analysis identified antiplatelet therapy as an nonsignifcant risk factor for bleeding-related outcome(OR=2.97, 95%CI: 0.87-10.21, P=0.08).
Conclusion:Preoperative dual antiplatelet therapy was not associated with increased risk of bleeding-related outcome and transfusion requirement, and was not a contraindication of emergent surgery for ATAAD patients.
