Back to Search
Start Over
When is the optimal time to discontinue clopidogrel before ināhospital coronary bypass surgery? A closer look at the current literature
- Source :
- Journal of Cardiac Surgery. 35:413-421
- Publication Year :
- 2019
- Publisher :
- Hindawi Limited, 2019.
-
Abstract
- Background Clopidogrel and other P2Y12 inhibitors have become the standard of care among patients presenting with acute coronary syndromes. A substantial proportion of these patients require surgical revascularization during index hospitalization. Hypothesis Guidelines recommend a 5-day waiting period off clopidogrel before coronary artery bypass grafting (CABG) to reduce hemorrhagic complications. These recommendations are not routinely followed in clinical practice, while recent studies also propose shorter waiting periods off clopidogrel for patients awaiting in-hospital CABG. Methods A preliminary PubMed search was conducted using the following MeSH terms under the publication type "Hemorrhage:" "Clopidogrel," AND "Coronary Artery Bypass." Relevant studies and guidelines were then reviewed and selected based on a predetermined criteria. Studies that formulated the current recommendations for stopping clopidogrel preoperative to CABG are discussed in detail this review. Results A comprehensive review of recent evidence illustrates mixed bleeding and transfusion outcomes among CABG patients with preoperative exposure to clopidogrel in less than 5 days. Conclusions The optimal discontinuation time of clopidogrel before CABG is still poorly defined. The recommendation of a 5-day washout period for clopidogrel should be reconsidered to be on par with current clinical practice.
- Subjects :
- Pulmonary and Respiratory Medicine
medicine.medical_specialty
Time Factors
Bypass grafting
Postoperative Hemorrhage
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
P2Y12
medicine
Humans
cardiovascular diseases
Coronary Artery Bypass
Intensive care medicine
business.industry
Clopidogrel
Time optimal
Discontinuation
030228 respiratory system
Bypass surgery
Hemorrhagic complication
Purinergic P2Y Receptor Antagonists
Surgery
Cardiology and Cardiovascular Medicine
Index hospitalization
business
circulatory and respiratory physiology
medicine.drug
Subjects
Details
- ISSN :
- 15408191 and 08860440
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiac Surgery
- Accession number :
- edsair.doi.dedup.....2498b09d298c4bedcc0f6e039ee3bc31