Stopping versus continuing acetylsalicylic acid before coronary artery bypass surgery: A systematic review and meta-analysis of 14 randomized controlled trials with 4499 patients.

Stopping versus continuing acetylsalicylic acid before coronary artery bypass surgery: A systematic review and meta-analysis of 14 randomized controlled trials with 4499 patients


Click on the title to purchase the article.


"This study aimed to evaluate the efficacy and safety of continuing versus stopping aspirin [acetylsalicylic acid (ASA)] preoperatively in patients undergoing coronary artery bypass graft surgery. MEDLINE, EMBASE, CENTRAL/Cochrane Controlled Trials Register (CCTR),, Scientific Electronic Library Online (SciELO), Literatura Latino Americana em Ciências da Saúde (LILACS), Google Scholar and reference lists of relevant articles were searched for randomized controlled trials that reported efficacy outcomes of myocardial infarction and mortality, and safety outcomes of blood loss, packed red blood cell transfusion and surgical re-exploration were compared between groups. Fourteen studies fulfilled our eligibility criteria and included a total of 4499 patients (2329 for ‘continuing ASA’ and 2170 for ‘stopping ASA’). In the pooled analysis, continuing aspirin therapy did not reduce the risk of myocardial infarction [risk ratio 0.834, 95% confidence interval (CI) 0.688–1.010; P = 0.063] or operative mortality (risk ratio 1.384, 95% CI 0.727–2.636; P = 0.323). Preoperative ASA increased postoperative chest tube drainage (mean difference 143 ml, 95% CI 39–248 ml; P = 0.007) and packed red blood cell transfusion (mean difference 142 ml, 95% CI 55–228; P = 0.001) but did not increase the risk of surgical re-exploration (risk ratio 1.316, 95% CI 0.910–1.905; P = 0.145). This meta-analysis found no statistically significant difference regarding the risk of operative mortality and myocardial infarction between the ‘continuing ASA’ and ‘stopping ASA’ strategies. On the other hand, the mean volume of blood loss and packed red blood cell transfusion was higher in the ‘continuing ASA’ group, but this finding did not translate into higher risk of reoperation for bleeding."1

1. Sá MPBO, Soares AF, Miranda RGA, Araújo ML, Menezes AM et al.
Eur J Cardiothorac Surg. 2017 Nov 1;52(5):838-847


Recent Stories
Delirium After Cardiac Surgery and Cumulative Fluid Balance: A Case-Control Cohort Study.

Hemolytic characteristics of three suctioning systems for use with a newly developed cardiopulmonary bypass system.

Direct Femoral Cannulation in Minimal Invasive Pediatric Cardiac Surgery: Our Experience With Midterm Result.

AmSECT Membership Eligibility

An Active Member shall be any perfusionist active in the practice of extracorporeal circulation technology. There are also opportunities to become a Transitional Active Member for those less than a year removed from graduation from an approved accredited training program. Other options include; an Associate Membership, International Membership, Perioperative Blood Management Clinician Membership, and Student Membership.

Click Here to Learn More

Looking for Employment Opportunities?

AmSECT members may post an available position for a perfusion specialty at your institution or firm.

Non-members may also post positions free of charge, to be reviewed by National Headquarters prior to posting.

Members - Click to Post a Position
Non-Members - Click to Post a Position

Contact AmSECT

AmSECT National Headquarters
330 N Wabash Ave, Suite 2000
Chicago, IL 60611

  Phone: (312) 321-5156
  Fax: (312) 673-6656

AmSECT © 2018 | View Privacy Policy | Site Map