IMR Press / RCM / Volume 22 / Issue 3 / DOI: 10.31083/j.rcm2203106
Open Access Original Research
The comparison between the effects of aspirin and clopidogrel monotherapy on postoperative bleeding in diabetic patients after off-pump coronary artery bypass surgery
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1 Department of Cardiovascular Surgery, Faculty of Medicine, Bülent Ecevit University, Kozlu, 67000 Zonguldak, Turkey
2 Department of Cardiovascular Surgery, Karabük University, Education and Research Hospital, Merkez, 78200 Karabük, Turkey
Academic Editor: Demosthenes B Panagiotakos
Rev. Cardiovasc. Med. 2021, 22(3), 975–981;
Submitted: 4 May 2021 | Revised: 5 July 2021 | Accepted: 21 July 2021 | Published: 24 September 2021
(This article belongs to the Special Issue Diet, nutrients and cardiovascular disease prevention)

There is limited data about the bleeding complication of antiplatelet therapy after coronary artery bypass graft (CABG) operations focused on diabetic patients. Herein, we aimed to evaluate the effects of aspirin and clopidogrel monotherapies on postoperative bleeding in these patients. A total of 165 diabetic patients who underwent isolated off-pump beating heart coronary artery bypass (OPCAB) operation were evaluated, 84 patients were included in this retrospective study. Patients were divided into groups according to the type of antiplatelet regime. Chest tube drainage amounts and the amount of blood product transfusions were evaluated. Acetylsalicylic acid (ASA) - group included 42 aspirin monotherapy and Clopidogrel - group included 42 clopidogrel monotherapy patients after propensity matching. The mean drainage amount in ASA - group was 670.24 ± 185.46 mL, in Clopidogrel - group was 921.43 ± 167.53 mL (p < 0.001). More packed red blood cell (PRBC) and fresh frozen plasma (FFP) units were needed in the Clopidogrel - group than in the ASA - group (2.05 ± 1.13 vs. 0.83 ± 0.93 units of PRBC, and 1.90 ± 0.58 vs. 1.05 ± 0.58 units of FFP, respectively, p < 0.001). In conclusion, clopidogrel had a stronger effect on bleeding in diabetic patients than aspirin after OPCAB surgery.

Coronary artery bypass
Postoperative hemorrhages
Platelet aggregation inhibitors
Diabetes complications
Fig. 1.
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