Retrospective Study on Perioperative Antithrombotic Drug Management in Coronary Heart Disease Patients Undergoing Elective Non-Cardiac Surgery in a Tertiary Hospital
10.3870/j.issn.1004-0781.2025.11.013
- VernacularTitle:某三甲医院择期非心脏手术冠心病患者围手术期抗血栓药物管理回顾性研究
- Author:
Rui XIONG
1
;
Juan WU
;
Anhua WEI
Author Information
1. 华中科技大学同济医学院附属同济医院药学部,武汉 430030;长江航运总医院·武汉脑科医院药学部,武汉 430010
- Publication Type:Journal Article
- Keywords:
Coronary heart disease;
Perioperative period;
Antithrombotic drug management
- From:
Herald of Medicine
2025;44(11):1798-1803
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the current clinical practices regarding perioperative discontinuation,bridging,and resumption of antiplatelet therapy in coronary heart disease(CHD)patients undergoing elective non-cardiac surgery or procedures,aiming to optimize perioperative antithrombotic management strategies.Methods A retrospective study was conducted on CHD patients requiring long-term oral antiplatelet therapy after percutaneous coronary intervention(PCI)who underwent elective non-cardiac surgery or procedures at a tertiary hospital in Hubei Province from January 1 to June 30,2024.Data on perioperative discontinuation,bridging,and resumption of antithrombotic drugs,as well as in-hospital bleeding events,were analyzed.Results A total of 338 hospitalized patients were included,with males accounting for 79.88%and the majority aged over 60 years.High bleeding-risk procedures comprised 56.61%of cases.Among 171 patients on single antiplatelet therapy(SAPT)preoperatively,8.19%continued therapy without interruption.Of the 157 patients who discontinued SAPT,67.25%received bridging therapy with low molecular weight heparin(LMWH),and 4.68%with sulodexide.Among 167 patients on dual antiplatelet therapy(DAPT)preoperatively,17.37%(29 cases)continued DAPT,while 122 discontinued it,with 85 receiving LMWH bridging.Postoperatively,58.64%(173/295)had not resumed antiplatelet therapy by discharge.Three intraoperative and 17 postoperative bleeding events(predominantly minor)were recorded.Conclusions Current perioperative antithrombotic management strategies for patients on long-term antiplatelet therapy undergoing elective surgery lack standardization,both domestically and internationally.Practices at this institution regarding drug discontinuation,bridging,and resumption diverged from guideline recommendations.However,the low observed bleeding rate and insufficient evidence highlight the need for well-designed clinical studies to address unresolved issues in perioperative antithrombotic management.
