Bleeding Outcomes in Patients Given Clopidogrel Within 5 Days of Robotic Coronary Artery Bypass Graft Procedure

Sophia Vainrub, Asad E. Patanwala, Richard Cosgrove, Robert Poston, Paul E. Nolan

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Current guidelines recommend that clopidogrel should be held for 5 days prior to coronary artery bypass graft (CABG) procedure. However, it is unknown if this recommendation should apply to robotic-assisted (rCABG), which is less invasive because it does not involve sternotomy and thus reduces the risk of bleeding. Objective: To compare postoperative bleeding for rCABG patients who were taking clopidogrel within 5 days of the procedure with those who were not taking clopidogrel. Methods: This was a retrospective cohort study conducted between January 1, 2012 and December 31, 2012 of consecutive patients undergoing rCABG. Patients were categorized into 2 groups based on whether or not clopidogrel was administered within 5 days prior to the date of surgery. The primary outcome measure was the occurrence of the Bleeding Academic Research Consortium (BARC) definition for CABG-related bleeding. The secondary outcome measure was a comparison of chest tube output during the first 24-hour postoperative period. Results: A total of 136 rCABG patients were included in the final analyses. Of these, 39 (29%) received clopidogrel within 5 days of surgery. CABG-related bleeding using the BARC definition occurred in 26% of patients who received clopidogrel and 8% of patients who did not (P = .011). Median chest tube output during the first 24-hour postoperative period was also greater in patients who received clopidogrel (900 vs 735 mL, P = .002). Conclusions: The use of clopidogrel within 5 days of rCABG is associated with greater postoperative bleeding and chest tube output, as defined by the BARC criteria.

Original languageEnglish (US)
Pages (from-to)48-53
Number of pages6
JournalAnnals of Pharmacotherapy
Volume48
Issue number1
DOIs
StatePublished - Jan 1 2014

Keywords

  • bleeding
  • clopidogrel
  • coronary artery bypass
  • platelet aggregation inhibitors

ASJC Scopus subject areas

  • Pharmacology (medical)

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