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Impact of Preoperative Clopidogrel Administration on Perioperative Blood Loss and Transfusion Requirements in Patients Undergoing Coronary Artery Bypass Graft Surgery



Bagheri K1 ; Safavi SMR1 ; Honarm A1 ; Attari M1 ; Nazem M2 ; Ahmadi J3 ; Khazaei M3
Authors
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Authors Affiliations
  1. 1. Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Department of Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Journal of Isfahan Medical School Published:2014

Abstract

Background: Clopidogrel is an adenosine-5' diphosphate (ADP) receptor antagonist that eventually inhibits platelet aggregation. It is used concomitantly with percutaneous coronary interventions and in patients with acute coronary diseases. This study was conducted to determine the effects of preoperative clopidogrel administration on perioperative blood loss and transfusion requirements in patients undergoing coronary artery bypass graft (CABG) surgery. Methods: For 100 patients who underwent nonurgent first-time coronary artery bypass grafting surgery participated in this study. clopidogrel was discontinued in 2, 3, 5-6 or 7-8 days before surgery. A cell salvage device was used during surgery and salvaged blood was recorded. After surgery, chest tube output and need for blood transfusion were measured and recorded. Findings: Patients' mean age was 61.7 ± 8.0 years (range: 50 to 77). There was a reverse relation between the time clopidogrel had been discontinued and blood loss and need for transfusion of packed cell and blood products during and after surgery (P < 0.05 for all). Conclusion: Preoperative clopidogrel administration increases perioperative blood loss and need for blood transfusion in patients undergoing coronary artery bypass grafting surgery.
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