SHM Converge Scientific Abstract ePoster Gallery-Perioperative Antiplatelet Management and Outcomes in Patients Undergoing Non-Cardiac Surgery: Real-Life Practices

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This study examined real-world perioperative antiplatelet management in patients undergoing elective low- and intermediate-bleeding-risk non-cardiac surgery or procedures. Current guidelines often recommend continuing aspirin in selected patients, but in practice it can be unclear how to balance thrombotic and bleeding risks.<br /><br />Researchers reviewed hospital admissions from January 2020 to October 2021 and identified 393 eligible patients taking single or dual antiplatelet therapy. Patients on anticoagulants or with bleeding disorders were excluded. The main comparison was between those who stopped all antiplatelet agents before surgery/procedure (STOP, n=243) and those who continued at least one antiplatelet agent (CON, n=150).<br /><br />Most patients were elderly men, and the commonest antiplatelet regimen was single therapy, usually aspirin. The two groups differed in baseline cardiovascular and vascular history, reflecting clinician selection of higher-thrombotic-risk patients for continuation.<br /><br />The key finding was that stopping all antiplatelet therapy was common and was associated with more postoperative major adverse cardiac events (MACE), especially at 30 and 90 days. MACE occurred in 4.1% vs 0.7% at 30 days and 4.9% vs 0.7% at 90 days in STOP vs CON groups, respectively. In contrast, major bleeding rates were similar between the two groups at 15, 30, and 90 days.<br /><br />Overall, the study suggests that in real-world practice, preoperative interruption of all antiplatelet agents is frequent even in lower-bleeding-risk elective non-cardiac surgery, and this strategy may increase postoperative cardiac risk without reducing major bleeding.

Asset Subtitle

Yongkasem Vorasettakarnkij

Meta Tag

Author List Athapol Anantasomboon, Yongkasem Vorasettakarnkij

Category Research

Concept Perioperative Antiplatelet Management

Concept Major Adverse Cardiovascular Event

Concept Elective Noncardiac Surgery

Concept Aspirin

Concept Antiplatelet Therapy

Distinguished Non-Finalist

Presenter Organization Chulalongkorn University

Presenting Author Yongkasem Vorasettakarnkij

Track Perioperative

Keywords

perioperative antiplatelet management

elective non-cardiac surgery

aspirin continuation

major adverse cardiac events

postoperative bleeding

single antiplatelet therapy

dual antiplatelet therapy

real-world study

preoperative interruption

thrombotic risk

Perioperative Antiplatelet Management

Major Adverse Cardiovascular Event

Elective Noncardiac Surgery

Aspirin

Antiplatelet Therapy