The majority of coronary patients are under anti-thrombotic therapy and its interruption may increase cardiovascular risk, while on the other hand, continuation during a surgical procedure may increase the risk of bleeding.
This study, which included 1211 patients who underwent non-cardiac surgery, compared the interruption of anti-thrombotic therapy at least 7 days prior vs continuing the therapy.
The majority of the patients (83.7%) were receiving anti-thrombotic therapy within one month of the surgery and the most frequent drug was aspirin (53.3%), followed by Warfarin, 23.4%.
The incidence of cardiovascular complications was 7.6% and perioperative bleeding, 13.3%. Of those who presented cardiovascular complications, 37.4% died compared with 1.26% of those who bled.
Conclusion:
This study showed that the interruption of anti-thrombotic therapy closer to surgery is not associated with the reduced risk of cardiovascular complications in the general population.
P. Widimsky
2013-09-02
Original title: PRAGUE 14: Perioperative ischemia versus perioperative bleeding in consecutive cardiac patients undergoing non-cardiac surgery.
