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The Effect of Preoperative Clopidogrel on the Postoperative Bleeding after OPCAB  

Park, Kwon-Jae (Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital)
Woo, Jong-Soo (Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital)
Bang, Jung-Hee (Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital)
Jeong, Sang-Seok (Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital)
Publication Information
Journal of Chest Surgery / v.42, no.3, 2009 , pp. 311-316 More about this Journal
Abstract
Background: Clopidogrel is widely used just before coronary artery bypass surgery, yet its pharmacological effect can cause postoperative bleeding-related complications. The purpose of this study was to find the effect of preoperative clopidogrel exposure on the blood transfusion requirement and on the rate of reexploration for bleeding control and the rate of readmission caused by bleeding in patients who undergo off-pump coronary artery bypass surgery (OPCAB). Material and Method: This study included 103 patients who had been on clopidogrel preoperatively and they underwent OPCAB by one surgeon from January, 2005 to November, 2007. We divided the patient into two group. Group 1 consisted of 45 patients who stopped cloidogrel 5 days before surgery and group 2 consisted of 58 patients who were taking clopidogrel within 5 days before surgery. Two groups were compared in terms of the bleeding related reoperation rate and the readmission rate, the amount of postoperative bleeding and the required amount of transfusion. Result: There were no significant differences between the two groups concerning the demographic, echocardiographic and hematologic features. There were no significant differences in the postoperative bleeding amount, but the amount of required transfusion was greater in group 2 (p=0.018). While group 1 showed a 0% reoperation rate for hemostasis and 0% readmission rate as related to postoperative bleeding, group 2 showed a 6.9% reoperation and a 5.2% readmission rate, but three were no statistically significant differences between the two groups. Conclusion: Continuous use of clopidogrel did not cause postoperative major bleeding, but can increase the amount of bleeding and the amount of required transfusion postoperatively. We that discontinuation of clopidogrel for a while before elective OPCAB can help the patient's postoperative recovery.
Keywords
Coronary artery bypass; Off-pump; Antiplatelets;
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