May 11 2005
Many patients who regularly take aspirin to thin their blood prior to undergoing coronary artery bypass surgery, have in the past been told to stop the aspirin a week before the operation, but new research has found that they may be better off taking it.
According to a report from Israel, it now seems that taking aspirin up to the day coronary artery bypass grafting (CABG) is performed, speeds up lung function recovery afterwards, without increasing the risk of bleeding significantly.
Dr. Rabin Gerrah at Assuta Medical Center in Tel Aviv and colleagues explain that the release of a substance called thromboxane is associated with lung injury after heart bypass grafting, and he believes Aspirin inhibits the release of thromboxane. Gerrah's group theorize that aspirin administration up until the day of surgery could improve outcomes.
The team followed 14 patients who took 100 milligrams of aspirin daily until the day of surgery and 18 whose aspirin therapy was stopped at least 7 days before surgery.
The investigators report that those who continued with their aspirin had significantly lower thromboxane in fluid around the heart, better oxygen levels in their blood, and spent less time on a ventilator than the group who discontinued taking aspirin.
But there was no difference between the groups in the need for blood transfusions which indicates that bleeding complications were no worse with aspirin.
The researchers excluded patients who had suffered a heart attack and those with heart failure, but because patients like these have a higher level of thromboxane, they will probably benefit even more from its inhibition.
Based on their findings, Gerrah's team recommends that aspirin therapy not be discontinued before coronary artery bypass surgery.
The findings are reported in the May edition of Chest.