Effect of preoperative anticoagulant and antitrombotic therapy on postoperative bleeding in coronary artery surgery

One of the most important problem in the patients who had coronary bypass surgery is bleeding. The antiplatelet and anticoagulant therapy used in coronary artery disease may increase bleeding. We have investigated the effect on postoperative drainage of acetylsalicylic acid and enoxaparin used preoperatively. One hundred and fiftyone patient operated between January 2008- July 2009 who had only coronary artery bypass surgery evaluated retrospectively. Patients who had reoperation, had extra cardiac surgery, used any antiplatelet or anticoagulant drug except aspirin and enoxaparin within five days before surgery, had coagulopathic disorders, had malignancy or died during surgery are excluded. Patients were divided into three groups. Group 1 (n=63) consists of patients who used coraspin 100 mg tbl. once a day and had on-pump coronary artery bypass grafting (CABG). Group 2 (n=55) consists of patients who used coraspin 100 mg tbl. once a day and had OPCAB. Group 3 (n=33) consists of patients who used clexane twice a day and had on-pump CABG. Descriptive tests are calculated by using one way ANOVA. Significant parameters are evaluated by Tukey HSD?s test and Tamhane test. Group 1 had greater amount of drainage postoperatively in contrast with group 2 and group 3. Group 2 and Group 3 had similar drainage levels. Enoxaparin instead of coraspin decreases the amount of drainage in patients who are suitable for on-pump CABG because can not be operated OPCAB. But patients who are planned to be operated using OPCAB methods can be treated with aspirin instead of enoxaparin because there isn?t any significant differance between them.KEYWORDS: hemorrhage, aspirin, enoxaparin, drainage, coronary bypass grafting, reoperation