Original article: cardiovascularDoes Clopidogrel Increase Blood Loss Following Coronary Artery Bypass Surgery?
Section snippets
Patients and Methods
Between July 1999 and April 2001, data were collected prospectively using our institutional database on 312 consecutive urgent or emergent CABG patients at the London Health Sciences Center. We observed the use of preoperative CL and its association with morbidity and mortality. Exclusion criteria included elective patient status, concominant valvular procedures, robotic cases, and bleeding disorders identified preoperatively. Patients with an elective status were excluded because they likely
Results
Preoperative patient demographics are outlined in Table 1. There were no clinically or statistically significant differences in age, gender, cardiac risk factors, or CCS class scoring. Patients in the three groups were also no different in terms of preoperative medications that may contribute to postoperative bleeding. However, there was a significant difference in expected hospital mortality and hospital length of stay scores.
The intraoperative data are presented in Table 2. Postoperative
Comment
We have shown that clopidogrel use within 4 days of coronary artery bypass surgery is associated with a number of adverse effects including increased blood loss and reoperation for bleeding. Despite all of the possible confounding factors as reflected in the differences among the groups in predicted hospital mortality and hospital length of stay, clopidogrel was identified as an independent risk factor for increased transfusion requirements and prolonged length of stay in the multivariable
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