接受替格瑞洛治疗的患者行冠状动脉旁路移植术与围手术期不良结局无关。
Coronary artery bypass graft surgery in patients on ticagrelor therapy is not associated with adverse perioperative outcomes.
机构信息
Division of Cardiovascular Medicine and Surgery, Poriya Medical Center, Tiberias, Israel.
The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.
出版信息
J Cardiothorac Surg. 2021 May 22;16(1):139. doi: 10.1186/s13019-021-01521-y.
BACKGROUND
Management of patients treated with Ticagrelor is challenging, as stopping Ticagrelor prior to coronary bypass graft surgery (CABG) may increase the risk of acute stent thrombosis. The aim of the study was to compare bleeding complications in patients treated with ticagrelor combined with acetylsalicylic acid (ASA) versus ASA alone until 1 day before surgery.
METHODS
Bleeding complications, defined as the composite of red blood cell transfusion ≥1000 ml, chest drainage ≥2000 ml, and bleeding requiring surgical re-exploration, were compared in 161 patients, with 101 on preoperative acetylsalicylic acid (ASA) alone (group A) and 65 on ticagrelor + ASA (group B).
RESULTS
There were no differences in bleeding complications between the two groups (26% vs. 27% in group A and B, respectively), with similar chest drainage in the first 24 h (569 ± 393 ml and 649 ± 427 ml, respectively).
CONCLUSIONS
Continuing ticagrelor until coronary artery bypass surgery was not associated with increased bleeding complications, suggesting that continued management with ticagrelor until surgery may be safe.
背景
接受替格瑞洛治疗的患者的管理具有挑战性，因为在冠状动脉旁路移植术 (CABG) 之前停止替格瑞洛可能会增加急性支架血栓形成的风险。本研究的目的是比较在手术前 1 天之前同时使用替格瑞洛和乙酰水杨酸 (ASA) 与单独使用 ASA 治疗的患者的出血并发症。
方法
在 161 例患者中比较了出血并发症，定义为红细胞输注≥1000ml、胸腔引流≥2000ml 和需要手术再次探查的出血的复合情况，其中 101 例患者术前单独使用乙酰水杨酸（ASA）（A 组），65 例患者使用替格瑞洛+ASA（B 组）。
结果
两组出血并发症无差异（A 组和 B 组分别为 26%和 27%），24 小时内胸腔引流相似（分别为 569±393ml 和 649±427ml）。
结论
继续使用替格瑞洛直至冠状动脉旁路移植术并未增加出血并发症的风险，这表明直至手术继续使用替格瑞洛可能是安全的。
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