Is Aspirin Safe Before Cardiovascular Surgery?

Aspirin before coronary artery surgery neither lowered risk of death or thrombotic complications nor raised the risk of bleeding when compared to placebo, according to a recent study.

Previous research has yet to discern whether patients with coronary artery disease should discontinue aspirin therapy before undergoing coronary artery surgery.
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To further examine this question, researchers conducted a 2-by-2 factorial trial in which 2100 participants randomly assigned to either aspirin or placebo. All participants were all scheduled to undergo coronary artery surgery.

Overall, death or thrombotic complication occurred in 202 patients in the aspirin group (19.3%) and 215 in the placebo group (20.4%). Major hemorrhage occurred in 1.8% of those in the aspirin group and 2.1% of the placebo group.

“Among patients undergoing coronary artery surgery, the administration of preoperative aspirin resulted in neither a lower risk of death or thrombotic complications nor a higher risk of bleeding than that with placebo,” they concluded.

—Michael Potts

Reference:

Myles PS, Smith JA, Forbes A, et al. Stopping vs. continuing aspirin before coronary artery surgery. N Engl J Med. 2016; 374:728-737.