There is great variability in the perioperative administration of aspirin (ASA) in patients undergoing noncardiac surgery, both those who had been receiving and those who not. This work included 10010 patients who planned to undergo noncardiac surgery and were randomized to aspirin versus placebo and clonidine versus placebo. Stratified according to whether they were receiving aspirin or not previously.The primary end point was a composite of death or nonfatal myocardial infarction occurred in 7% of the aspirin group and 7.1% in the placebo group (p = 0.92).Major bleeding was more common in the aspirin group (4.6 % versus 3.8 %, p = 0.04).
Conclusion
Giving aspirin before noncardiac surgery and in the immediate postoperative period had no significant effect on the combined primary end point of death and myocardial infarction; there was a significant increase in bleeding.
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P.J. Devereaux
2014-03-31
Original title: The Impact of Acetyl-Salicylic Acid on Major Arterial and Venous Complications in Patients Undergoing Noncardiac Surgery.