Comparison of aspirin plus heparin with heparin alone on asymptomatic
perioperative deep vein thrombosis in candidates for elective off-pump coronary
artery bypass graft: a randomized clinical trial.
Author(s): Mirhosseini SJ(1), Forouzannia SK, Mostafavi Pour Manshadi SM, Ali-Hassan-Sayegh
S, Naderi N, Sanatkar M.
Affiliation(s): Author information:
(1)s_m_yousof_mostafavi@yahoo.com.
Publication date & source: 2013, Cardiol J. , 20(2):139-43
BACKGROUND: Symptomatic or asymptomatic deep vein thrombosis (DVT) is a common
complication following coronary artery bypass graft (CABG), in which less than 1%
of these patients suffer from clinically evident pulmonary embolism (PE). DVT and
PE can increase other morbidities of coronary revascularization from short to
long period, but no clear consensus still exists regarding proper
thromboprophylaxis strategy in the literatures. This study was designed to
compare the anti-platelet prophylaxis of aspirin plus heparin with heparin alone
on asymptomatic perioperative DVT in patients that are candidates for elective
off-pump CABG.
METHODS: One hundred and twenty patients, who are candidates for elective
off-pump CABG, were randomly assigned to two groups: the aspirin plus heparin
group (Group 1, n = 60) that received 80 mg daily aspirin orally and 5000 U
unfractionated heparin per 8 h subcutaneously from admission to discharge time,
and the heparin group (group 2, n = 60) that received same dose of heparin alone.
All patients underwent right and left leg venous ultrasound examination during
hospitalization, after which post-operative off-pump CABG complications such as
deep vein thrombosis, bleeding and pulmonary embolism were evaluated in this
study cases.
RESULTS: The mean age of the patients was 62.10 ± 10.71 years with a male to
female ratio of 2.24. Asymptomatic DVT occurred in 12 (10%) patients who
underwent elective off-pump CABG. DVT was found more in Group 2 (16.6%) as
compared to Group 1 (3.3%) with statistical significant difference (p = 0.015).
Bleeding was detected in 5 (4.1%) cases in the patients sampled in this study (p
= 0.34), 4 cases of which are from Group 1 and 1 case from Group 2. However, PE
was shown in none of this study cases.
CONCLUSIONS: The incidence of DVT decreased more with aspirin plus heparin as
compared to heparin alone in patients who underwent elective off-pump CABG. As
regards the results obtained in this study, more studies need to be conducted to
establish this strategy for prophylaxis of DVT in CABG.
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