Abstract 3221: Impact of Thienopyridines on Re-Operation Rates, Bleeding Outcomes and Hospitalization in ACS Patients Requiring CABG Surgery
Objective: The objective of this retrospective observational study is to examine the impact of preoperative administration of clopidogrel on re-operation rates, incidence of life-threatening bleeding, inpatient length of stay (LOS) and other bleeding-related outcomes in ACS patients requiring CABG in a broad cross-section of US hospitals. This is the first study designed with this objective to be conducted in multiple centers.
Methods: A retrospective cohort analysis of ACS patients requiring CABG surgery during their index hospitalization was completed. Each site randomly selected 40–50 cases divided into the two comparison groups which consisted of patients exposed to clopidogrel versus those not exposed to clopidogrel within 5 days prior to surgery.
Results: Data from the first 361 patients in 12 hospitals are reported. The two groups were comparable at baseline in terms of age, gender and co-morbidities. The rate of re-operation in the exposed group was 6.3% vs. 1.5% (p = 0.016) in those not exposed within 5 days. The number of patients who experienced excessive or life-threatening bleeding was higher in the exposed group; total inpatient LOS was not significantly different. Patients in the exposed group also required more blood product transfusions.
Relationship between Clopidogrel Exposure and LOS, Markers for Life Threatening Bleeding, and Reoperation - Interim Analysis, 12 sites reporting
Conclusion: Exposure to clopidogrel within 5 days before CABG surgery in ACS patients appears to significantly increase the need for re-operation and major bleeding outcomes in a broad cross-section of hospitals.