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Rodino AM, Henderson JB, Dobbins KF, et al. Impact of Thrombocytopenia on Postoperative Bleeding Incidence in Patients Receiving Aspirin Following Coronary Artery Bypass Grafting. J Pharm Pract. 2020;897190020966193doi: 10.1177/0897190020966193.
Rodino, A. M., Henderson, J. B., Dobbins, K. F., Rubin, D. T., & Hollis, I. B. (2020). Impact of Thrombocytopenia on Postoperative Bleeding Incidence in Patients Receiving Aspirin Following Coronary Artery Bypass Grafting. Journal of pharmacy practice, 897190020966193. https://doi.org/10.1177/0897190020966193
Rodino, Anne M, et al. "Impact of Thrombocytopenia on Postoperative Bleeding Incidence in Patients Receiving Aspirin Following Coronary Artery Bypass Grafting." Journal of pharmacy practice vol. (2020): 897190020966193. doi: https://doi.org/10.1177/0897190020966193
Rodino AM, Henderson JB, Dobbins KF, Rubin DT, Hollis IB. Impact of Thrombocytopenia on Postoperative Bleeding Incidence in Patients Receiving Aspirin Following Coronary Artery Bypass Grafting. J Pharm Pract. 2020 Oct 21;897190020966193. doi: 10.1177/0897190020966193. Epub 2020 Oct 21. PMID: 33084455.
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J Pharm Pract. 2020 Oct 21;897190020966193. doi: 10.1177/0897190020966193. Epub 2020 Oct 21.

Impact of Thrombocytopenia on Postoperative Bleeding Incidence in Patients Receiving Aspirin Following Coronary Artery Bypass Grafting.

Journal of pharmacy practice

Anne M Rodino, James B Henderson, Kelsey F Dobbins, Deanna T Rubin, Ian B Hollis

Affiliations

  1. Department of Pharmacy, 24560Northwestern Memorial Hospital, Chicago, IL, USA.
  2. Department of Pharmacy, 3065Duke University Hospital, Durham, NC, USA.
  3. Department of Pharmacy, 537791WakeMed Health and Hospitals, Raleigh, NC, USA.
  4. 15521UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA.
  5. Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC, USA.

PMID: 33084455 DOI: 10.1177/0897190020966193

Abstract

BACKGROUND: Early postoperative aspirin following coronary artery bypass graft (CABG) surgery has been shown to maintain bypass graft patency, reduce mortality, and prevent adverse cardiovascular events. Despite this known benefit, aspirin may be delayed due to thrombocytopenia and perceived higher bleeding risk. The purpose of this study was to assess the impact of postoperative platelet count on bleeding in patients receiving aspirin after CABG.

METHODS: A retrospective analysis included all patients who underwent CABG surgery at our institution from April 2014 to June 2018 and received aspirin within 24 hours. The primary outcome was International Society on Thrombosis and Hemostasis (ISTH) major bleeding within 7 days (or up to discharge) following CABG surgery compared between patients with and without postoperative thrombocytopenia.

RESULTS: This study included 280 patients. Major bleeding occurred in 24.6% of the population, with no difference when stratified by the presence or absence of postoperative thrombocytopenia (27.3% versus 23.8%, p = 0.571). There was no significant difference in hemoglobin fall (13.6% versus 14%, p = 0.948), transfusion requirement (6.1% versus 4.2%, p = 0.531), or critical site bleeding (12.1% versus 7.9%, p = 0.298).

CONCLUSION: In this single-center analysis of patients who received aspirin within 24 hours of CABG, postoperative thrombocytopenia was not associated with an increase in bleeding.

Keywords: aspirin; coronary artery bypass; hemorrhage; platelet count; thrombocytopenia

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