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Perioperative aspirin benefits patients with PCIs
ORLANDO, Fla. — In patients with prior PCI undergoing noncardiac surgery, aspirin demonstrated more benefits than harms, according to a presentation at Hospital Medicine 2018.
“In the original POISE-2 study, the authors couldn’t draw conclusions about whether aspirin benefited patients with prior PCI,” Barbara Slawski, MD, MS, said during her presentation. “This year, there was a subgroup analysis of the POISE-2 trial published in PCI patients.”
In the main POISE-2 study, 10,010 patients at high CV risk undergoing noncardiac surgery were randomly assigned to receive aspirin — initiated or continued — or placebo — patients previously taking aspirin stopped before surgery.
Patients implanted with a bare-metal stent within 6 weeks before surgery or with a drug-eluting stent within 1 year before surgery were excluded. A total of 470 patients with prior PCI (mean age, 68 years; 22% women) were enrolled.
Patients with PCIs who were treated with aspirin had lower rates of death or nonfatal MI than those treated with placebo, Slawski said. Additionally, aspirin-treated patients with PCIs did not have higher rates of bleeding than placebo treated patients, she said.
“The accrued rates of major life-threatening bleeding in the aspirin vs. placebo patients, it’s a bit higher in both groups, but it’s not statistically significant in patients with prior PCI and it is statistically significant in patients who did not have prior PCI,” she said.
“The authors concluded that perioperative aspirin in patients with previous PCI appears to provide more benefit than harm,” she added.
“Personally, when I see a patient who has a PCI who is undergoing noncardiac surgery, I continue their aspirin unless I think there’s going to be a catastrophic reaction,” Slawski concluded. – by Alaina Tedesco and Erik Swain
Reference:
Cooper C, Slawski B. Hospital medicine update. Presented at: Hospital Medicine 2018; April 9-11; Orlando, Fla.
Disclosure: Slawski reports no relevant financial disclosures.