Aspirin before cardiac surgery reduces postoperative cardiocerebral complications

A study presented at the American Society of Anesthesiologists 2010 Annual Meeting revealed that use of aspirin before cardiac surgery reduced postoperative cardiocerebral complications, including stroke, myocardial ischemia, heart block and cardiac arrest by more than 33 percent when compared to patients who did not use aspirin.

The research also showed that preoperative aspirin use reduced postoperative kidney failure by 55 percent, the requirement of dialysis by 74 percent, and it did not cause an obvious increase in postoperative bleeding, which is a common reason for readmission to the hospital after certain cardiac surgeries.

"Although tremendous progress has been made in the field of cardiac surgery over the past four decades, the clinical preventive therapy to reduce major cardiocerebral and renal complications associated with surgery, including heart attack, stroke and renal failure, has been scant and ineffective, while these complications remain common, significant and costly, especially for older and sicker patients," said Jian-Zhong Sun, M.D., of the Anesthesiology Department at Thomas Jefferson University.

In non-surgical settings, aspirin use has become an important cornerstone in treating cardiovascular disease, and it has been known to improve the outcomes of patients with risk of cardiovascular disease. But, according to Dr. Sun, there is still no proven clinical therapy to prevent major adverse cardiocerebral and renal events in cardiac surgery patients.

Such a proven therapy could be critically important to physicians because the majority of patients presenting for cardiac surgery are increasingly older and sicker and thus vulnerable to complications involving the heart, brain and kidneys.

In this retrospective cohort study, led by first author Longhui Cao, M.D. and lead author Dr. Sun, 1,148 patients were divided into two groups: those taking aspirin and those not. Significantly, patients in the aspirin group were more likely to be older, have hypertension, diabetes, peripheral artery disease, previous myocardial ischemia, angina, and a history of coronary artery disease.

"Although the patients in the aspirin group were older and sicker, our study showed that preoperative use of aspirin significantly reduced major adverse cardiocerebral events and renal failure in this group," said Dr. Sun. "Thus, our work supports previous study findings from non-surgical patients that aspirin protects the heart, brain and kidney against these major risk factors, indicating a potential application to older and sicker patients undergoing cardiac surgery."