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Preoperative Aspirin Use and Outcomes in Cardiac Surgery Patients

Cao, Longhui MD, PhD*,#; Young, Nilas MD§; Liu, Hong MD; Silvestry, Scott MD; Sun, Will MS; Zhao, Ning PhD; Diehl, James MD; Sun, Jianzhong MD, PhD*

doi: 10.1097/SLA.0b013e318234313b
Original Articles
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Background: The effects of preoperative aspirin use on outcomes of cardiac surgery patients remain uncertain. This study was aimed to evaluate the effect of preoperative aspirin use on major outcomes in cardiac surgery patients.

Methods: An observational cohort study was performed on consecutive patients (n = 4256) undergoing cardiac surgery in 2 tertiary hospitals. Of all patients, 2868 patients met the inclusion criteria and were divided into 2 groups: those taking (n = 1923) or not taking (n = 945) aspirin within 5 days preceding surgery.

Results: Patients in the aspirin group presented significantly more with comorbidities including hypertension, diabetes, peripheral arterial disease, previous myocardial infarction, angina, cerebrovascular disease, older age, and male gender. With propensity scores adjusted and multivariate logistic regression, however, the results of this study showed that preoperative aspirin therapy (vs nonaspirin) significantly reduced the risk of 30-day mortality (3.5% vs 6.5%, OR: 0.611, 95% CI: 0.391–0.956, P = 0.031), postoperative renal failure (3.7% vs 7.1%, OR: 0.384, 95% CI: 0.254–0.579, P < 0.001), dialysis required (1.9% vs 3.6%, OR: 0.441, 95% CI: 0.254–0.579, P < 0.001), intensive care unit stay (mean 107.2 vs 136.1 h, P < 0.001) and a composite outcome-major adverse cardiocerebral events (8.7% vs 10.8%, OR: 0.662, 95% CI:: 0.482–0.909, P = 0.011) in the patients undergoing cardiac surgery. However, readmissions did not show a significant difference between the 2 groups (14.5% vs 12.8%, P = 0.944).

Conclusions: Preoperative aspirin therapy is associated with a significant decrease in the risk of major cardiocerebral complications, renal failure, intensive care unit stay and 30-day mortality but does not increase the risk of readmissions in patients undergoing cardiac surgery.

This observational cohort study from two university hospitals showed that preoperative aspirin therapy was associated with a significant decrease in the risk of major adverse cardiocerebral complications, renal failure, ICU stay and 30-day mortality but did not increase the risk of readmissions in patients undergoing cardiac surgery.

*Department of Anesthesiology,

Division of Cardiothoracic Surgery,

Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA;

§Division of Cardiothoracic Surgery,

Department of Anesthesiology and Pain Medicine, University of California Davis Medical Center, Sacramento, CA;

Department of Psychiatry, University of Pennsylvania Health System, PA;

#Anesthesiology Department, State Key Laboratory in South China, Sun Yat-Sen University Cancer Center, Guangzhou, China.

Reprints: Jianzhong Sun, MD, PhD, Department of Anesthesiology, Suite G8490, 111 South 11th Street, Philadelphia, PA 19107. E-mail: jian-zhong.sun@jefferson.edu.

Disclosure: The authors declare that they have nothing to disclose.

© 2012 Lippincott Williams & Wilkins, Inc.