Effect of preoperative aspirin use on mortality in coronary artery bypass grafting patients

Background. Discontinuing aspirin use in patients before coronary artery by pass grafting (CABG) has focused on bleeding risks. The effect of aspirin u se on overall mortality with this procedure has not been studied. Methods. We performed a case patient-control patient study of the 8,641 con secutive isolated CABG procedures performed between July 1987 and May 1991 in Maine, New Hampshire, and Vermont. Patients included all 368 deaths. Eac h case patient was paired with approximately two matched survivors (control patients). Aspirin use was defined by identification of ingestion within 7 days before the operation. Results. CABG patients using preoperative aspirin were less likely to exper ience in-hospital mortality in univariate (odds ratio [OR] = 0.73, 95% conf idence interval [0.54 0.97]) and multivariate [OR = 0.55, (0.31, 0.98)] ana lysis compared to nonusers. No significant difference was seen in the amoun t of chest tube drainage, transfusion of blood products, or need for reexpl oration for hemorrhage between patients who did and did not receive aspirin . Conclusions. Preoperative aspirin use appears to be associated with a decre ased risk of mortality in CABG patients without significant increase in hem orrhage, blood product requirements, or related morbidities. (Ann Thorac Su rg 2000;70:1986-90) (C) 2000 by The Society of Thoracic Surgeons.