[Aspirin withdrawal in high risk cardiac patients before the operation of total colectomy with resection of ileum--case report].
2013
Coronary artery disease is one of the risk factors for myocardial infarction
and it is present in 40% of patients who are undergoing noncardiac surgery.
Despite evidence of the benefit of the antiplatelet therapy in patients at
risk of cardiac complications, aspirin treatment is often discontinued before
surgery due to the risk of perioperative bleeding. In many studies and
meta-analysis it is shown that aspirin withdrawal in perioperative period was
associated with three-fold higher risk of major adverse cardiac events.
Perioperative continuation of aspirin increase the rate of bleeding by 1.5,
but it doesn’t increase the level of the severity of bleeding complications.
In perioperative periode aspirin is discontinued only if it is estimated that
the bleeding risk is higher than the risk of thrombosis. In the paper authors
present a case report of patient who developed a perioperative myocardial
infarction as a consequence of aspirin withdrawal before total colectomy.
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