4.6 Review

Aspirin and coronary artery surgery: a systematic review and meta-analysis

期刊

BRITISH JOURNAL OF ANAESTHESIA
卷 115, 期 3, 页码 376-385

出版社

ELSEVIER SCI LTD
DOI: 10.1093/bja/aev164

关键词

aspirin; blood transfusion; coronary artery bypass; myocardial infarction

资金

  1. Australian National Health and Medical Research Council Practitioner Fellowship, Melbourne, Australia

向作者/读者索取更多资源

Background: Aspirin administration before cardiac surgery represents a balance between preventing perioperative thrombotic events and promoting surgical bleeding. Clear evidence to guide the preoperative use of aspirin in patients undergoing cardiac surgery is lacking. This systematic review and meta-analysis was performed to evaluate the efficacy and safety of preoperative aspirin, in patients undergoing coronary artery surgery. Methods: We conducted a systematic review and meta-analysis of randomized trials involving patients undergoing coronary artery surgery assigned to preoperative aspirin therapy or no aspirin/placebo. The MEDLINE and EMBASE databases and Cochrane Central Register of Controlled Trials were searched up to March 2014 without language restrictions. Two reviewers performed independent quality review and data extraction. Efficacy outcomes of myocardial infarction (MI) and mortality, and safety outcomes of blood loss, red cell transfusion, and surgical re-exploration were compared. Results: In 13 trials (n=2399), preoperative aspirin therapy reduced the risk of MI (OR, 0.56; 95% CI, 0.33-0.96; P=0.03), without a reduction in mortality (OR, 1.16; 95% CI, 0.42-3.22; P=0.77). Preoperative aspirin increased postoperative chest tube drainage (mean difference 168 ml; 95% CI, 39-297 ml; P=0.01), red cell transfusion (mean difference 141 ml; 95% CI, 55-226; P=0.001) and need for surgical re-exploration (OR, 1.85, 95% CI, 1.15-2.96; P=0.01). Studies were of low methodological quality, with significant heterogeneity identified. Conclusions: In patients undergoing coronary artery surgery, preoperative aspirin reduces perioperative MI, but at a cost of increased bleeding, blood transfusion, and surgical re-exploration.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.6
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据