Aspirin May Benefit Patients With Prior PCI Undergoing Noncardiac Surgery

Aspirin tied to reduced risk of mortality, myocardial infarction for patients undergoing noncardiac surgery
Aspirin tied to reduced risk of mortality, myocardial infarction for patients undergoing noncardiac surgery

HealthDay News — For patients with prior percutaneous coronary intervention (PCI), perioperative aspirin seems to be beneficial, according to a study published online November 13 in the Annals of Internal Medicine.

Michelle M. Graham, MD, from the University of Alberta in Canada, and colleagues performed a subgroup analysis of a multicenter trial to assess data for adults age ≥45 years who had or were at risk for atherosclerotic disease and were undergoing noncardiac surgery; 4,998 patients in the overall trial and 234 participants in the subgroup analysis received aspirin therapy, while 5,012 patients in the overall trial and 236 in the subgroup analysis received placebo initiated within four hours before surgery. 

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The researchers found that aspirin reduced the risk of the 30-day primary outcome of death or nonfatal myocardial infarction (absolute risk reduction, 5.5%; 95% confidence interval [CI], 0.4 to 10.5%; hazard ratio [HR], 0.5; 95% CI, 0.25 to 0.95 [P=0.036]) and the risk of myocardial infarction (absolute risk reduction, 5.9%; 95% CI, 1 to 10.8%; HR, 0.44; 95% CI, 0.22 to 0.87 [P=0.021]) in patients with prior PCI. In addition, the effect on the composite of major and life-threatening bleeding in patients with prior PCI was uncertain (absolute risk increase, 1.3 percent; 95% CI, −2.6 to 5.2%). Aspirin was correlated with increased risk for major bleeding in the overall population (absolute risk increase, 0.8%; 95% CI, 0.1 to 1.6%; HR, 1.22; 95% CI, 1.01 to 1.48 [P=0.5]).

"Perioperative aspirin may be more likely to benefit rather than harm patients with prior PCI," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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