Dual Antiplatelet Therapy before Coronary Artery Bypass Grafting; a Systematic Review and Meta-Analysis

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SADEGHI ROXANA; Babahajian Asrin; SARVEAZAD ARASH; KACHOUEIAN NASER; BAHARDOUST MANSOUR

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Journal: Archives of Academic Emergency Medicine Year:2020 | Volume:8 | Issue:1 Page(s): 0-0

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Title

Dual Antiplatelet Therapy before Coronary Artery Bypass Grafting; a Systematic Review and Meta-Analysis

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Keywords

Dual anti-platelet therapy

coronary artery bypass

acute coronary syndrome

aspirin

clopidogrel

Abstract

Introduction: Currently, the basis of acute coronary syndrome (ACS) therapy is dual antiplatelet therapy (DAPT) with aspirin as a nonsteroidal anti-inflammatory drug and clopidogrel as adenosine diphosphate receptor antagonists. Therefore, the aim of the present systematic review is to answer that should DAPT with aspirin and clopidogrel be continued until coronary artery bypass grafting (CABG) in patients who have ACS? Methods: The search for relevant studies in the present meta-analysis is based on three approaches: A) systematic searches in electronic databases, B) manual searches in Google and Google Scholar, and C) screening of bibliography of related original and review articles. The endpoints included mortality rate, myocardial infarction (MI), cerebrovascular accident (CVA), reoperation, re-exploration, other cardiac events, renal failure, length of ICU and hospital stay, chest tube drainage and blood product transfusion after CABG. Results: After the initial screening, 41 articles were studied in detail, and finally the data of 15 studies were included in the meta-analysis. DAPT before CABG in patients with ACS does not increase the rate of mortality, CVA, renal failure, MI, and other cardiac events, but increases reoperation, re-exploration, length of ICU, and hospital stay. Chest tube drainage and blood product transfusion rate significantly increased in the DAPT group compared to the control group (non-antiplatelet or aspirin alone). Increase in chest tube drainage and blood product transfusion rate indicates an increase in bleeding, so increase in reoperation, re-exploration to control bleeding, and, subsequently, increase in the length of ICU and hospital stay are expected. Conclusion: DAPT with aspirin and clopidogrel before CABG in patients with ACS does not increase the rate of mortality, CVA, renal failure, MI, and other cardiac events despite more bleedings, and it may be suggested before CABG for better graft patency.

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APA: Copy

SADEGHI, ROXANA, Babahajian, Asrin, SARVEAZAD, ARASH, KACHOUEIAN, NASER, & BAHARDOUST, MANSOUR. (2020). Dual Antiplatelet Therapy before Coronary Artery Bypass Grafting; a Systematic Review and Meta-Analysis. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE (EMERGENCY), 8(1), 0-0. SID. https://sid.ir/paper/339849/en

Vancouver: Copy

SADEGHI ROXANA, Babahajian Asrin, SARVEAZAD ARASH, KACHOUEIAN NASER, BAHARDOUST MANSOUR. Dual Antiplatelet Therapy before Coronary Artery Bypass Grafting; a Systematic Review and Meta-Analysis. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE (EMERGENCY)[Internet]. 2020;8(1):0-0. Available from: https://sid.ir/paper/339849/en

IEEE: Copy

ROXANA SADEGHI, Asrin Babahajian, ARASH SARVEAZAD, NASER KACHOUEIAN, and MANSOUR BAHARDOUST, “Dual Antiplatelet Therapy before Coronary Artery Bypass Grafting; a Systematic Review and Meta-Analysis,” ARCHIVES OF ACADEMIC EMERGENCY MEDICINE (EMERGENCY), vol. 8, no. 1, pp. 0–0, 2020, [Online]. Available: https://sid.ir/paper/339849/en

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