Does the time between preoperative interruption of aspirin intake and operation influence postoperative blood loss and transfusion requirement in coronary artery bypass graft?

Objective: Impact of the interval between interruption of aspirin intake and surgery on postoperative bleeding and transfusion in coronary artery bypass graft (CABG), with extracorporeal circulation (ECC). Study design: Retrospective study. Patients and methods: Four hundred and twelve patients having undergone CABG were retrospectively reviewed. Three groups were evaluated according to the length of the interval defined above : Group I (< 3 days), Group II (3 - 7 days), Group III (> 7 days or without aspirin intake). Postoperative blood loss at 3(rd), 6(th), 12(th), and 24(th) hour and transfusion requirements were assessed for the 3 groups. Aprotinin (low dose, 2 M KIU) was systematically included in the priming of the ECC circuit. Results: There were no significant differences among groups for weight, size, duration of ECC, and number of bypasses. No significant correlation was noted among the 3 groups for postoperative blood loss and transfusion. Multivariate analysis showed that factors associated to a higher risk of excessive bleeding were ECC duration and number of arterial grafts. Factors associated with a higher risk of transfusion were: emergency, minimum patient temperature during ECC, weight and preoperative haemoglobin level. Aspirine intake was not associated with an increase of bleeding or transfusion. Conclusion: Our study showed that in our practice using systematic low dose of aprotinin when priming the ECC circuit, aspirin did not significantly increase bleeding or transfusion requirements in CABG with ECC, whatever the interval between interruption of aspirin intake and surgery. Consequently, in our practice, aspirin intake is interrupted on hospitalisation, one day before surgery. (C) 2002 Editions scientifiques et medicales Elsevier SAS.