aspirin before surgery benefits bypass patients
- From: "zee" <fresh~horses@xxxxxxxxxxxxx>
- Date: 30 Aug 2005 22:22:35 -0700
Health
Aspirin Before Surgery Benefits Bypass Patients
By Ed Edelson
HealthDay Reporter
http://www.forbes.com/lifestyle/health/feeds/hscout/2005/08/29/hscout527685.html
MONDAY, Aug. 29 (HealthDay News) -- People taking low-dose aspirin to
help their hearts benefit substantially if they continue to take it in
the days before they have bypass surgery, a new Mayo Clinic study
indicates.
The researchers looked at more than 1,600 people who had bypass
operations at the Mayo Clinic between 2000 and 2002, and found that the
in-hospital death rate for those who took aspirin in the five days
before surgery was 1.7 percent, compared to 4.4 percent for those who
didn't.
Some surgeons have patients stop taking aspirin before the operation
for fear of excessive bleeding. But the study found no increased
incidence of re-operation because of internal bleeding, said Dr. R.
Scott Wright, the Mayo cardiologist who was the lead author of the
report in the Aug. 30 issue of Circulation.
"We were pleased to find that the perioperative death rate was
significantly lower, as well as cerebrovascular events [strokes],"
Wright said. "And in those who took aspirin, there was a reduced need
for postoperative blood products."
The in-hospital death rate is lowered because the aspirin does what it
is supposed to do -- prevent heart attacks and other cardiac events by
making blood flow more freely, he added.
"We know that many of the deaths that occur after the operation are due
to ischemic heart disease," in which a coronary blood vessel is
blocked, Wright said.
But although the study supports the findings of smaller studies done in
other countries, the case for giving aspirin before bypass surgery is
not definitively proved, he said.
"This is level 2 evidence, an observational study," Wright said. "A
randomized trial is needed for definitive evidence. The data from this
study would justify carrying out a randomized trial in patients getting
bypass study."
"These new data from the Mayo Clinic certainly help support the case
for using aspirin before surgery," said Dr. Eric Topol, chairman of the
department of cardiovascular medicine at the Cleveland Clinic.
The case for using aspirin immediately after bypass surgery has been
proven by a number of studies showing major benefits, Topol said, but
there has been a debate about its use before surgery because "the data
has been a bit mixed about bleeding hazard and graft success."
The Mayo study shows that "the bleeding hazard doesn't appear to be in
any way prohibitive," Topol said.
In practice, surgeons at the Cleveland Clinic generally continue use of
aspirin if the bypass patient already has been taking it, he said. But
it is not yet standard procedure to start a patient on aspirin in the
days before surgery, unless there are unusual features, such as a high
risk of a heart attack, Topol said.
The new report is another indicator of the value of aspirin in the
treatment of heart disease, Wright said.
"Patients with heart disease who are not taking aspirin should ask
themselves -- and their doctors -- 'Why not?'" he added.
More information
The role of aspirin in heart disease and stroke is explained by the
American Heart Association.
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