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Current Drug Safety

Editor-in-Chief

ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

Oral Antiplatelet Agents and Bleeding Risk in Relation to Major Cardiovascular Surgery

Author(s): James McCaslin, Jonathan Smout, Patrick Kesteven and Gerard Stansby

Volume 1, Issue 3, 2006

Page: [281 - 287] Pages: 7

DOI: 10.2174/157488606777934486

Price: $65

Abstract

Introduction: Patients requiring major cardiovascular surgery are likely to be prescribed antiplatelet agents either alone or in combination. By virtue of antiplatelet agent effect, they can potentially increase bleeding complications, especially if used in combination. This article aims to review the evidence and make appropriate recommendations regarding these agents. Aspirin: 16 papers are reviewed which concern surgery whilst taking aspirin. The bulk of the evidence is from the coronary bypass setting. Clopidogrel: 14 papers are reviewed which concern surgery whilst taking clopidogrel. Dipyridamole: 2 papers are reviewed concerning dipyridamole. Cilostazol: No trials are available concerning surgery and cilostazol. Several relevant publications are reviewed. Conclusion: It is the recommendation of the authors that aspirin should usually be continued perioperatively, whilst clopidogrel should be stopped for seven days prior to surgery if at all possible.

Keywords: Aspirin, platelet aggregation inhibitors, cardiac surgical procedures, vascular surgical procedures, haemorrhage, post-operative complications


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