{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:22:42Z","timestamp":1787757762822,"version":"build-2784847793"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>The purpose of this study was to review the effect of the pre-operative use of clopidogrel and aspirin on peri-operative bleeding, blood product transfusion, and resource utilization after coronary artery bypass grafting (CABG).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A total of 1200 patients who underwent off-pump CABG (OPCABG) between 2010 and 2012 were retrospectively studied. Patients were divided into three groups: group 1: discontinued aspirin and clopidogrel 6 days prior to surgery (n = 468), group 2: discontinued both drugs 3 to 5 days prior to surgery (n = 621), and group 3: discontinued both drugs 2 days prior to surgery (n = 111). The bleeding pattern and blood product transfusion were studied and compared between the groups. Patients having history of other drugs affecting the coagulation profile, other organ dysfunction, on-pump CABG, and the combined procedure were excluded from the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Group 2 patients had a higher rate of bleeding and a reduced mean value of hemoglobin (Hb) as compared to other groups. The same results were seen in blood and blood product transfusion. Patients of group 2 and group 3 were associated with higher blood loss in terms of drainage at 12 and 24 hours. Post-operatively, this was statistically significant. Re-exploration was statisitically significant in group 3 patients (9.01%) than in group 2 (2.58%) and group 1 (1.07%) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The pre-operative use of clopidogrel and aspirin in patients undergoing OPCABG showed limited clinical benefits; however, its use significantly increased the risk of bleeding and blood transfusion, thus increasing morbidity and resource utilization. Hence, clopidogrel and aspirin should be stopped at least 6 days prior to surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aca.aca_12_22","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T08:24:24Z","timestamp":1649665464000},"page":"182-187","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Effect of Anti-Platelet Therapy on Peri-Operative Blood Loss in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting"],"prefix":"10.4103","volume":"25","author":[{"given":"Samir","family":"Kapoor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurmeet","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh Chand","family":"Arya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikrampal","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Garg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarju","family":"Ralhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek Kumar","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bishav","family":"Mohan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurpreet Singh","family":"Wander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv Kumar","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-10-20240901","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/S0002-8703(96)90231-8","article-title":"Reduction in angioplasty complications after the introduction of coronary stents: Results from a consecutive series of 2242 patients","volume":"132","author":"Altmann","year":"1996","journal-title":"Am Heart J"},{"key":"R2-10-20240901","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1161\/01.CIR.0000140675.85342.1B","article-title":"Benefits and risks of the combination of clopidogrel and aspirin in patients undergoing surgical revascularization for non-ST-elevation acute coronary syndrome: The clopidogrel in unstable angina to prevent recurrent ischemic events (CURE) trial","volume":"110","author":"Fox","year":"2004","journal-title":"Circulation"},{"key":"R3-10-20240901","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1097\/01.CCM.0000217920.48559.D8","article-title":"Morbidity and mortality risk associated with red blood cell and blood-component transfusion in isolated coronary artery bypass grafting","volume":"34","author":"Koch","year":"2006","journal-title":"Crit Care Med"},{"key":"R5-10-20240901","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1046\/j.1365-2044.2003.02960.x","article-title":"The thienopyridine derivatives pharmacology and clinical developments","volume":"58","author":"Kam","year":"2003","journal-title":"Anaesthesia"},{"key":"R6-10-20240901","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1136\/hrt.2005.084830","article-title":"Intervention in acute coronary syndromes: Do patients undergo intervention on the basis of their risk characteristics. 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