Heart surgeons don't have to choose between taking a coronary-bypass patient off the popular anti-clotting drug clopidogrel (Plavix) after off-pump heart bypass surgery or having the patient bleed excessively in the days following surgery, according to a new study by researchers at Jefferson Medical College.
The study, presented recently at the American College of Cardiology's 56th annual scientific session, found that Plavix, when used in addition to aspirin, will not worsen bleeding after off-pump heart bypass surgery.
The researchers, led by David Whellan, M.D., assistant professor of medicine at Jefferson Medical College of Thomas Jefferson University, conducted a retrospective study of more than 7,000 patients who underwent off-pump heart bypass surgery. They report that the anti-platelet drug program appears safe — post-surgery — when used with aspirin. Overall, they found that patients who took clopidogrel and aspirin experienced less gastrointestinal bleeding, and fewer strokes and other cardiovascular complications than patients who were on aspirin alone.
"The new off-pump strategy is a proven surgical advance in the treatment of heart disease," said Whellan.
"Improving outcomes for patients undergoing bypass surgery and keeping the new bypass grafts open is a critical issue. One possible strategy is to use clopidogrel, but there have been safety concerns, particularly regarding the risk of bleeding after surgery."
The researchers used data provided by the University HealthSystem Consortium, an alliance of 97 academic medical centers and 149 of their affiliated hospitals representing nearly 90 percent of the nation's nonprofit academic medical centers. The data were culled from more than 800 institutions, including more than 70 academic medical centers.
Data was used from patients who underwent off-pump coronary artery bypass surgery, known as OPCABG, and were treated with aspirin alone, or with aspirin and clopidogrel.