loading page

Outcomes of Preoperative Antiplatelet Therapy in Patients with Acute Type A Aortic Dissection
  • +3
  • Xuan Jiang,
  • Enyi Shi,
  • Ruixin Fan,
  • Ximing Qian,
  • Hongjia Zhang,
  • Tianxiang Gu
Xuan Jiang
Author Profile
Ruixin Fan
Author Profile
Ximing Qian
Author Profile
Hongjia Zhang
Author Profile
Tianxiang Gu
Author Profile

Abstract

Background: Acute type A aortic dissection(ATAAD) is life-threatening and requires immediate surgery. Sudden chest pain may lead to a risk of misdiagnosis as acute coronary syndrome and may lead to subsequent antiplatelet therapy. We used the Chinese Acute Aortic Syndrome Collaboration Database (AAS) to study the effects of antiplatelet therapy (APT) on clinical outcomes. Methods: The AAS database is a retrospective multicentre database where 31 of 3092 had APT with aspirin or clopidogrel or both before surgery. Before and after propensity score matching, the incidence of complications and mortality was compared between APT and non-APT patients by using a logistic regression model. The sample remaining after PSM was 30 in the APT group and 80 in the non-APT group. Results: The sample remaining after matching was 30 in the APT group and 80 in the non-APT group. We found 10 cases with percutaneous coronary intervention in the APT group(33.3%). The APT group received more volume of packed red blood cell (RBC), 8.4±6.05 units; plasma, 401.67±727 ml, and platelet transfusion(14.07±8.92 units). The drainage volume was much more in the APT group( 5009.37±2131.44ml, P=0.004). Mortality was higher in APT group(26% vs 10%, P=0.027). The preoperative APT was independent predictor of mortality(OR 6.808, 95% CI1.554-29.828, P = 0.011). Conclusion: APT prior to ATAAD repair was associated with more transfusions and higher early mortality. The timing of surgery should be carefully considered based on the patient’s status and the surgeon’s experience.

Peer review status:IN REVISION

30 Jul 2021Submitted to Journal of Cardiac Surgery
30 Jul 2021Assigned to Editor
30 Jul 2021Submission Checks Completed
01 Aug 2021Reviewer(s) Assigned
11 Sep 2021Review(s) Completed, Editorial Evaluation Pending
13 Sep 2021Editorial Decision: Revise Major