GAO Ge , HU Shengshou , ZHENG Zhe , et al .
  • Department of Cardiac Surgery，Fu Wai Hospital, Chinese Academy of Medical Sciences &;
  • Peking Union Medical College， Beijing 100037， P.R.China.;
Coronary artery bypass grafting; Antiplatelet therapy; Clopidogrel; Bleeding; Blood transfusion
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Objective [WTBZ]To assess the impact of dual antiplatelet therapy using aspirin and clopidogrel on postoperative bleeding and blood transfusion early after coronary artery bypass grafting (CABG). Methods [WTBZ]In this randomized controlled trial, 249 patients were randomly assigned to 2 groups after coronary artery bypass grafting from December 2007 to December 2008. Daily clopidogrel (75 mg) and aspirin (100 mg) were initiated in 124 patients (group AC) while aspirin (100 mg) alone was administered to 125 patients (group A). Antiplatelet therapy was initiated within 48h postoperatively. Demographic, operative, and postoperative data were compared between the two groups. Chest tube drainage and quantity of blood products used in both groups were recorded. The effects of the antiplatelet regimen on chest tube drainage were compared using a linear regression model. Results [WTBZ]No statistical difference of demographic, operative, and preoperative data was observed between the two groups （P gt;0.05）. Chest tube drainage after patients received ntiplatelet agents was not significantly different between group A and group AC（495.00±270.89 ml vs. 489.25±316.68ml，t=0.146, P=0.884）. No statistical difference of cases of transfusion(81 cases vs. 91 cases，χ2=1.937, P=0.164) or quantity of red cells (2.51±2.88 U vs. 2.25±2.87 U, t=0.690, P=0.491) and plasma (195.45±300.88 ml vs. 223.01±238.68 ml,t=0.759, P=0.449) transfused was found between group A and group AC. No perioperative mortality, reexploration or extrathoracic bleeding occurred in either group. Early postoperative use of dual antiplatelet therapy was not associated with increased bleeding after coronary artery bypass grafting on multivariable analysis（r=2.297，95%CI:-64.526,69.121，P=0.946）. Conclusionpresent study suggests that according to a predefined administration protocol, dual antiplatelet therapy of aspirin and clopidogrel can safely be administered in the early postoperative period in CABG patients, without increasing the risk of bleeding complications.

Citation： GAO Ge,HU Shengshou,ZHENG Zhe,et al .. Impact of Dual Antiplatelet Therapy on Postoperative Bleeding and Blood Transfusion in Coronary Artery Bypass Grafting. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2010, 17(1): 1-5. doi: Copy