PREOPERATIVE ASPIRIN DECREASES PLATELET-AGGREGATION AND INCREASES POSTOPERATIVE BLOOD-LOSS - A PROSPECTIVE, RANDOMIZED, PLACEBO-CONTROLLED, DOUBLE-BLIND CLINICAL-TRIAL IN 100 PATIENTS WITH CHRONIC STABLE ANGINA

被引：108

作者：

KALLIS, P

TOOZE, JA

TALBOT, S

COWANS, D

BEVAN, DH

TREASURE, T

机构：

[1] Harefield Hospital, Harefield, Middlesex

[2] Cardiothoracic Unit and Department of Haematology, St. George’s Hospital, London

[3] Cardiothoracic Unit, The Middlesex Hospital, London, W1N8AA, Mortimer Street

来源：

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | 1994年 / 8卷 / 08期

关键词：

ASPIRIN; CARDIAC SURGERY; BLEEDING; PLATELET FUNCTION;

D O I：

10.1016/1010-7940(94)90081-7

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aspirin has an established benefit in reducing the incidence of coronary events and vein graft occlusion. We have now assessed the risk of pre-operative aspirin in a prospective, randomised, double-blind clinical trial in 100 patients scheduled for elective coronary artery surgery. Any prescribed aspirin and non-steroidal anti-inflammatory drugs were discontinued 2 weeks pre-operatively and these were replaced by a randomly assigned tablet of either aspirin 300 mg daily or placebo taken until the day of surgery. Patient compliance was confirmed by serum and urinary salicylate analysis. The two groups were similar in demographic characteristics, bypass time, number of grafts placed and number of internal mammary arteries used. All patients survived to be discharged home (see Table). Aspirin decreases platelet aggregation to arachidonic acid and to collagen both pre- and post-operatively. The benefit of pre-operative aspirin has to be balanced against the risk of increasing post-operative blood loss, re-exploration for excessive bleeding and transfusion requirements.

引用

页码：404 / 409

页数：6

共 31 条

[1] Boldt J., Knothe C., Zickmann B., Herold C., Dapper F., Hempel-Mann G., The effects of preoperative aspirin therapy on platelet function in cardiac surgery, Eur J Cardio-Thorac Surg, 6, pp. 598-602, (1992)
[2] Bowie E., Solberg L.A., Fass D.N., Johnson C.M., Knutson G.J., Stewart M.L., Zoecklein L.J., Transplantation of normal bone marrow into a pig with severe von Willebrand’s disease, J Clin Invest, 78, pp. 26-30, (1986)
[3] Chesebro J.H., Clements I.P., Fuster V., Elveback L.R., Smith H.C., Bardsley W.T., Frye R.L., Holmes D.R., Vlietstra R.E., Pluth J.R., Wallace R.B., Puga F.J., Orszulak T.A., Piehler J.M., Schaff H.V., Danielson G.K., A platelet-inhibitor-drug trial in coronary artery bypass operations. Benefit of perioperative dipyridamole and aspirin therapy on early postoperative vein-graft patency, N Engl J Med, 307, pp. 73-78, (1982)
[4] Ferraris V.A., Ferraris S.P., Lough F.C., Berry W.R., Preoperative aspirin ingestion increases operative blood loss after coronary artery bypass grafting, Ann Thorac Surg, 45, pp. 71-74, (1988)
[5] Flower R.J., Blackwell G.J., The importance of phospholi-pase A2 in prostaglandin biosynthesis, Biochem Pharmacol, 25, pp. 285-291, (1976)
[6] Fressinaud E., Baruch D., Rothschild C., Baumgartner H.R., Meyer D., Platelet von Willebrand Factor: Evidence for its involvement in platelet adhesion to collagen, Blood, 70, pp. 1214-1217, (1986)
[7] Fuster V., Chesebro J.H., Role of platelets and platelet inhibitors in aortocoronary artery vein-graft disease, Circulation, 73, pp. 227-232, (1986)
[8] Gavaghan T.P., Gebski V., Baron D.W., Immediate postoperative aspirin improves vein graft patency early and late after coronary bypass graft surgery. A placebo-controlled, randomised study, Circulation, 83, pp. 1526-1533, (1991)
[9] Gay W.A., Aspirin, blood loss, and transfusion, Ann Thorac Surg, 50, (1990)
[10] Goldman S., Copeland J., Moritz T., Henderson W., Zadina K., Ovitt T., Kern K.B., Sethi G., Sharma G., Khuri S., Richards K., Grover F., Morrison D., Johnston M., Chesler E., Sako Y., Pa-Cold I., Montoya A., Demots H., Floten S., Doherty J., Read R., Scott S., Spooner T., Masud Z., Haakenson C., Harker L.A., Internal mammary artery and saphenous graft patency. Effects of aspirin, Circulation, 82, pp. 237-242, (1990)

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