Original articleAdult cardiacClopidogrel Increases Blood Transfusion and Hemorrhagic Complications in Patients Undergoing Cardiac Surgery
Section snippets
Material and Methods
Approval for conducting this study was obtained by the Instituitonal Review Board of the Capital District Health Authority. We note that the need for individual patient consent for this study was waived by the Review Board.
Patient Population
This study included 3,779 consecutive patients undergoing isolated CABG, isolated valve surgery, or CABG plus valve surgery. In the study, 26.4% of patients (999) received clopidogrel preoperatively and of those, 74.3% (742) presented to the operating room within 5 days of receiving clopidogrel. Compared with patients not prescribed clopidogrel, preoperative clopidogrel use was associated with higher transfusion (43.6% [436] versus 30.7% [854], p = 0.0001) and hemorrhagic complication (4.9%
Comment
The objective of this study was to determine the relationship between the outcomes of interest and the clopidogrel stop interval. We found that patients receiving clopidogrel within 24 hours of surgery experienced significantly higher transfusion rates and that transfusion rates decreased as the clopidogrel stop interval increased. Using logistic regression, we identified clopidogrel administration within 24 hours of surgery as an independent predictor of blood product transfusion (OR 2.4) and
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