Is Preoperative Clopidogrel Resistance a Predictor of Bleeding and Risks in Patients Undergoing Emergency CABG Surgery?
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| Format: | Artículo científico |
| Langue: | en |
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Sociedade Brasileira de Cirurgia Cardiovascular
2018
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| _version_ | 1876432682042261504 |
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| author | Mehmet Kizilay |
| author_facet | Mehmet Kizilay |
| contents | Is Preoperative Clopidogrel Resistance a Predictor of Bleeding and Risks in Patients Undergoing Emergency CABG Surgery? Mehmet Kizilay Zeynep Aslan Unsal Vural Ahmet Yavuz Balci Ahmet Arif Aglar Sahin Yilmaz Medicina Thienopyridines Coronary Artery Bypass Acute Coronary Syndrome Platelet Aggregation Inhibitors Objective: The aims of this study were to determine whether the detection of preoperative clopidogrel resistance in patients undergoing cardiac surgery while using clopidogrel could play a guiding role in the prediction of postoperative excessive bleeding, transfusion requirements, and risks and to provide clinically significant data.Methods: Two hundred and twenty-two patients median age: 59.4 (38-83) years; 38 females undergoing emergency and elective coronary artery bypass graft (CABG) surgeries in our clinic were evaluated prospectively. Patients with multiple systemic diseases, other than diabetes mellitus (DM) and hypertension (HT), were excluded. Patients receiving clopidogrel were also evaluated for clopidogrel resistance and grouped according to the results of this test. Assessments of platelet functions were performed by multiplate impedance aggregometry method and adenosine diphosphate test.Results: The use of postoperative fresh blood replacement and platelet transfusion was higher in patients receiving clopidogrel than in those not receiving it (P=0.001, P=0.018). DM, HT, myocardial infarction, and the number of presentation to the emergency room were significantly higher in patients receiving clopidogrel than in those not receiving it (P<0.05). No significant difference was determined between patients with and without clopidogrel resistance regarding the amount of bleeding during and after surgery, erythrocyte suspension and fresh-frozen plasma transfusion rates, preoperative troponin values, ejection fraction values, and length of hospital stays (P>0.05).Conclusion: We think that resistance studies in patients receiving clopidogrel before cardiac surgery are not efficient to predict bleeding and bleeding-related complications in patients undergoing emergency and elective CABG surgeries. 2018 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398956442005 https://www.redalyc.org/journal/3989/398956442005/ https://www.redalyc.org/journal/3989/398956442005/html/ https://www.redalyc.org/journal/3989/398956442005/398956442005.epub https://www.redalyc.org/journal/3989/398956442005/movil 10.21470/1678-9741-2018-0005 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.4 Vol.33 |
| format | Artículo científico |
| id | redalyc_398956442005 |
| institution | Redalyc |
| language | en |
| publishDate | 2018 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| spellingShingle | Is Preoperative Clopidogrel Resistance a Predictor of Bleeding and Risks in Patients Undergoing Emergency CABG Surgery? Mehmet Kizilay Medicina Thienopyridines Coronary Artery Bypass Acute Coronary Syndrome Platelet Aggregation Inhibitors Is Preoperative Clopidogrel Resistance a Predictor of Bleeding and Risks in Patients Undergoing Emergency CABG Surgery? Mehmet Kizilay Zeynep Aslan Unsal Vural Ahmet Yavuz Balci Ahmet Arif Aglar Sahin Yilmaz Medicina Thienopyridines Coronary Artery Bypass Acute Coronary Syndrome Platelet Aggregation Inhibitors Objective: The aims of this study were to determine whether the detection of preoperative clopidogrel resistance in patients undergoing cardiac surgery while using clopidogrel could play a guiding role in the prediction of postoperative excessive bleeding, transfusion requirements, and risks and to provide clinically significant data.Methods: Two hundred and twenty-two patients median age: 59.4 (38-83) years; 38 females undergoing emergency and elective coronary artery bypass graft (CABG) surgeries in our clinic were evaluated prospectively. Patients with multiple systemic diseases, other than diabetes mellitus (DM) and hypertension (HT), were excluded. Patients receiving clopidogrel were also evaluated for clopidogrel resistance and grouped according to the results of this test. Assessments of platelet functions were performed by multiplate impedance aggregometry method and adenosine diphosphate test.Results: The use of postoperative fresh blood replacement and platelet transfusion was higher in patients receiving clopidogrel than in those not receiving it (P=0.001, P=0.018). DM, HT, myocardial infarction, and the number of presentation to the emergency room were significantly higher in patients receiving clopidogrel than in those not receiving it (P<0.05). No significant difference was determined between patients with and without clopidogrel resistance regarding the amount of bleeding during and after surgery, erythrocyte suspension and fresh-frozen plasma transfusion rates, preoperative troponin values, ejection fraction values, and length of hospital stays (P>0.05).Conclusion: We think that resistance studies in patients receiving clopidogrel before cardiac surgery are not efficient to predict bleeding and bleeding-related complications in patients undergoing emergency and elective CABG surgeries. 2018 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398956442005 https://www.redalyc.org/journal/3989/398956442005/ https://www.redalyc.org/journal/3989/398956442005/html/ https://www.redalyc.org/journal/3989/398956442005/398956442005.epub https://www.redalyc.org/journal/3989/398956442005/movil 10.21470/1678-9741-2018-0005 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.4 Vol.33 |
| title | Is Preoperative Clopidogrel Resistance a Predictor of Bleeding and Risks in Patients Undergoing Emergency CABG Surgery? |
| topic | Medicina Thienopyridines Coronary Artery Bypass Acute Coronary Syndrome Platelet Aggregation Inhibitors |
| url | https://www.redalyc.org/articulo.oa?id=398956442005 https://www.redalyc.org/journal/3989/398956442005/ https://www.redalyc.org/journal/3989/398956442005/html/ https://www.redalyc.org/journal/3989/398956442005/398956442005.epub https://www.redalyc.org/journal/3989/398956442005/movil |