Effect of clopidogrel on perioperative blood loss and transfusion in coronary artery bypass graft surgery patients
Akmal M.A. Badreldin 1*,
Axel Kroener 2,
Hiroyuki Kamiya 1,
Artur Lichtenberg 1,
Khosro Hekmat 1
1 University of Jena, Germany
2 University of Cologne, Germany
* To whom correspondence should be addressed. E-mail: akmalbadreldin{at}yahoo.com.
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Abstract |
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The effect of antiplatelet therapy (APT) on postoperative bleeding, transfusion needs and re-exploration remains unclear. This study examines the influence of APT, as well as antiplatelet mono- and combined therapy, on haemorrhage and transfusion requirements in patients undergoing coronary artery bypass on cardiopulmonary bypass (CPB). 650 patients were reviewed retrospectively, 325 patients received APT within 7 days and 325 control patients. APT group had two subgroups: clopidogrel (CLO) group: n=48 patients received CLO as mono-therapy; combined group: n=277 patients received both CLO and aspirin (ASS). The mediastinal drainage at 12 h was control group: 505 ml±445 ml and APT: 802 ml±720 ml, p<0.001. APT group (versus control group) received significantly more units of blood (3.9±4.2 versus 1.9±2.6; p<0.001), platelet units (1.0±1.4 versus 0.1±0.3; p<0.001), and fresh frozen plasma (FFP) units (2.9±3.9 versus 0.9±2.2; p<0.001), respectively. Combined and mono-therapy groups had no significant differences in bleeding and blood transfusion. Considerations should be given to delaying elective coronary surgery for patients received APT for 7 days. Keywords: Clopidogrel; CABG; Antiplatelet therapy; Postoperative bleeding
