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Fırat University Medical Journal of Health Sciences
2020, Cilt 34, Sayı 2, Sayfa(lar) 155-160
[ Turkish ] [ Tam Metin ] [ PDF ]
The Effect of Preoperative Clopidogrel Use on Postoperative Bleeding in Patients with Emergency or Early Coronary Bypass Surgery
Sadettin CÖHCEN1, Sadiye Deniz ÖZSOY2, Mehmet Ali YEŞİLTAŞ3, Ayhan UYSAL4, İsmail HABERAL2
1Sağlık Bilimleri Üniversitesi, Haseki Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi İstanbul, TÜRKİYE
2İstanbul Üniversitesi, Cerrahpaşa, Kardiyoloji Enstitüsü, Kalp ve Damar Cerrahisi İstanbul, TÜRKİYE
3Sağlık Bilimleri Üniversitesi, Dr.Sadi Konuk Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi İstanbul, TÜRKİYE
4Fırat Üniversitesi, Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Elazığ, TÜRKİYE
Keywords: Clopidogrel, bleeding, coronary bypass

Objective: Bleeding is still a major problem after coronary artery bypass surgery (CABG), despite all the improvements. Antiplatelet drugs which are proven to reduce ischemic cardiac events are used very frequently. Nowadays, the number of patients, who need emergency CABG while clopidogrel treatment, are increasing. We investigated the effects of preoperative clopidogrel use on postoperative bleeding in emergency CABG.

Materials and Methods: In this study, between 2015 and 2017, we have compared 66 patients who had emergency CABG while clopidogrel treatment due to coronary artery disease with 68 patients who had elective CABG without clopidogrel in terms of the amount of bleeding, blood products and revisions needed. Patients who had multiple procedures or additional cardiac diseases were excluded.

Results: From the total 134 patients (n: 101) 75.4% were male and 24.6% (n: 33) were female. 49.3% (n: 66) of the patients were using clopidogrel, while 50.7% (n: 68) of them were not. The postoperative drainage was 410(150-1300) mL in group with clopidogrel, while it was 640(150-2750) mL in the other group. The drainage volume was significantly higher in the group without clopidogrel (P<0.001). The number of fresh frozen plasma and platelet suspension that used during procedure was higher in the group using clopidogrel (P<0.001).

Conclusion: Emergency CABG under clopidogrel treatment with sufficient management of bleeding and adequate use of blood products, can be performed with acceptable results.


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