Department of Cardiovascular Surgery, HeBei PetroChina Central Hospital, Langfang 065000, China.
Department of Cardiovascular Surgery, General Hospital of Northern Theatre Command, Shenyang 110000, China.
Contrast Media Mol Imaging. 2022 Jul 8;2022:8674401. doi: 10.1155/2022/8674401. eCollection 2022.
Coronary artery bypass grafting (CABG) is widely used to treat coronary artery disease, and intraoperative and postoperative bleeding is one of the major factors affecting the efficacy and mortality of CABG. To overcome the adverse effects of extracorporeal circulation (CPB), nonextracorporeal coronary artery bypass grafting (OPCABG) has become the main modality of CABG but is still prone to thromboembolic events. Whether antiplatelet agents should be clinically applied before CABG, especially OPCABG, remains controversial. Aspirin is currently the most important perioperative oral antiplatelet agent for coronary artery bypass graft surgery. In this study, we evaluated the effect of continuing aspirin therapy before OPCABG and observed perioperative performance and physiological indicators to find evidence for continuing aspirin therapy before surgery in China. The study showed that preoperative aspirin application had a positive effect on enhancing early postoperative platelet inhibition without increasing the incidence of adverse effects such as cardiovascular events. This provides an important clinical reference for whether antiplatelet agents should be applied before CABG, especially OPCABG.
冠状动脉旁路移植术(CABG)被广泛用于治疗冠状动脉疾病,术中及术后出血是影响 CABG 疗效和死亡率的主要因素之一。为了克服体外循环(CPB)的不良影响,非体外循环下冠状动脉旁路移植术(OPCABG)已成为 CABG 的主要方式,但仍容易发生血栓栓塞事件。在 CABG 之前,特别是 OPCABG 之前,是否应临床应用抗血小板药物仍存在争议。阿司匹林是目前冠状动脉旁路移植术围手术期最重要的口服抗血小板药物。在本研究中,我们评估了 OPCABG 前继续应用阿司匹林治疗的效果,并观察了围手术期表现和生理指标,以寻找在中国术前继续阿司匹林治疗的证据。研究表明,术前应用阿司匹林可积极增强术后早期血小板抑制作用,而不增加心血管事件等不良反应的发生率。这为是否应在 CABG 之前,特别是 OPCABG 之前应用抗血小板药物提供了重要的临床参考。