Khan Muhammad Yasir, Khan Adnan Zafar, Jalal Anjum, Zaman Haider
Dr. Muhammad Yasir Khan, MCPS, FCPS, FCPS, MRCS. Department of Cardiac Surgery, Chaudhary Pervaiz Elahi Institute of Cardiology, Multan, Pakistan.
Dr. Adnan Zafar Khan, MBBS, MSc. Health economics. Department of Health Punjab, Lahore, Pakistan.
Pak J Med Sci. 2017 Jan-Feb;33(1):106-110. doi: 10.12669/pjms.331.11563.
BACKGROUND & OBJECTIVE: Antiplatelet drugs are frequently used after coronary artery bypass graft (CABG) surgery to prevent venous graft occlusion. The fear of bleeding complications prevents them to be given early post operatively, which is the time when antiplatelets use confers maximum benefit. Our objective was to determine the effect and influence of early aspirin therapy on fatal and nonfatal bleeding complications and blood requirements after coronary bypass surgery (CABG).
The patients who only underwent coronary artery bypass surgery for the first time in the past three years and did not have any bleeding diathesis were retrospectively analyzed from the cardiac surgery database of CPEIC Multan. The patients either received aspirin within six hours of CABG or had it given after 12 hours. The patients were analyzed for mean blood loss and number of blood units transfused. SPSS was used for statistical analysis. P value < 0.05 was considered significant.
Total 281 patients received aspirin within six hours while 326 patients did not. Mean blood loss in early aspirin group was 727ml as compared to 767ml in the other group (p value 0.74). The median number of blood units transfused was 2 (p value 0.98). Our results did not show any statistical difference in both the groups.
Aspirin can safely be given early after CABG without the fear of bleeding complications thus conferring the advantage of increased graft patency.
冠状动脉搭桥术（CABG）后常使用抗血小板药物预防静脉移植物闭塞。对出血并发症的担忧使得这些药物无法在术后早期使用，而术后早期使用抗血小板药物获益最大。我们的目的是确定早期阿司匹林治疗对冠状动脉搭桥手术（CABG）后致命和非致命性出血并发症及血液需求量的影响。
从木尔坦CPEIC的心脏手术数据库中回顾性分析过去三年仅首次接受冠状动脉搭桥手术且无任何出血倾向的患者。这些患者在CABG后6小时内接受阿司匹林治疗或在12小时后给药。分析患者的平均失血量和输血单位数量。使用SPSS进行统计分析。P值<0.05被认为具有统计学意义。
281例患者在6小时内接受阿司匹林治疗，326例患者未接受。早期阿司匹林组的平均失血量为727ml，另一组为767ml（P值0.74）。输血单位数量的中位数为2（P值0.98）。我们的结果显示两组之间无任何统计学差异。
CABG后早期可安全使用阿司匹林，无需担心出血并发症，从而具有提高移植物通畅率的优势。
