Safety of clopidogrel being continued until the time of coronary artery bypass grafting in patients with acute coronary syndrome: A meta-analysis of 34 studies

European Heart Journal

Volumn 32, Issue 23, 2011, Pages 2970-2988

  Nijjer, Sukhjinder S ^a   Watson, Geoff ^a   Athanasiou, Thanos ^b   Malik, Iqbal S ^a  

^a HAMMERSMITH HOSPITAL   (United Kingdom)

^b ST MARY S HOSPITAL   (United Kingdom)

Author keywords

Acute coronary syndrome (ACS); Bleeding; Clopidogrel; Coronary artery bypass surgery (CABG); Mortality; Myocardial infarction; Transfusion

Indexed keywords

CLOPIDOGREL;

ACUTE CORONARY SYNDROME; ARTICLE; CLINICAL ASSESSMENT; COMPARATIVE STUDY; CORONARY ARTERY BYPASS GRAFT; DEATH; DRUG SAFETY; HEART INFARCTION; HUMAN; MAJOR CLINICAL STUDY; META ANALYSIS; MORTALITY; POSTOPERATIVE COMPLICATION; PRIORITY JOURNAL; STROKE; THORAX DRAINAGE;

ACUTE CORONARY SYNDROME; BLOOD TRANSFUSION; CORONARY ARTERY BYPASS; FEMALE; HEMORRHAGE; HUMANS; INTENSIVE CARE; LENGTH OF STAY; MALE; MYOCARDIAL INFARCTION; PLATELET AGGREGATION INHIBITORS; POSTOPERATIVE COMPLICATIONS; PREOPERATIVE CARE; REOPERATION; RESEARCH DESIGN; RISK ASSESSMENT; RISK FACTORS; STROKE; TICLOPIDINE; TREATMENT OUTCOME;

EID: 82455201598     PISSN: 0195668X     EISSN: 15229645     Source Type: Journal    
DOI: 10.1093/eurheartj/ehr151     Document Type: Article

References (75)

1. Yusuf S, Zhao F, Mehta SR, Chrolavicius S, Tognoni G, Fox KK. Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 2001;345:494-502. (Pubitemid 32758501)
2. Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr, Chavey WE 2nd, Fesmire FM, Hochman JS, Levin TN, Lincoff AM, Peterson ED, Theroux P, Wenger NK, Wright RS, Smith SC Jr, Jacobs AK, Halperin JL, Hunt SA, Krumholz HM, Kushner FG, Lytle BW, Nishimura R, Ornato JP, Page RL, Riegel B. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction). Circulation 2007;116:e148-e304.
3. Steinhubl SR, Berger PB, Mann JT 3rd, Fry ET, DeLago A, Wilmer C, Topol EJ; CREDO Investigators. Clopidogrel for the reduction of events during observation early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial. JAMA 2002;288:2411-2420. (Pubitemid 35340537)
4. Mehta RH, Chen AY, Pollack CV Jr, Roe MT, Zalenski RJ, Clements EA, Gibler WB, Ohman EM, Harrington RA, Peterson ED. Challenges in predicting the need for coronary artery bypass grafting at presentation in patients with non-ST-segment elevation acute coronary syndromes. Am J Cardiol 2006;98: 624-627. (Pubitemid 44233458)
5. Berger JS, Frye CB, Harshaw Q, Edwards FH, Steinhubl SR, Becker RC. Impact of clopidogrel in patients with acute coronary syndromes requiring coronary artery bypass surgery: a multicenter analysis. J Am Coll Cardiol 2008;52:1693-1701.
6. Eagle KA, Guyton RA, Davidoff R, Edwards FH, Ewy GA, Gardner TJ, Hart JC, Herrmann HC, Hillis LD, Hutter AM Jr, Lytle BW, Marlow RA, Nugent WC, Orszulak TA, Antman EM, Smith SC Jr, Alpert JS, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Gregoratos G, Halperin JL, Hiratzka LF, Hunt SA, Jacobs AK, Ornato JP. ACC/AHA 2004 guideline update for coronary artery bypass graft surgery: summary article: American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1999 Guidelines for Coronary Artery Bypass Graft Surgery). Circulation 2004;110: 1168-1176. (Pubitemid 39328205)
7. Dunning J, Versteegh M, Fabbri A, Pavie A, Kolh P, Lockowandt U, Nashef SA; EACTS Audit and Guidelines Committee. Guideline on antiplatelet and anticoagulation management in cardiac surgery. Eur J Cardiothorac Surg 2008;34:73-92.
8. Mahla E, Metzler H, Tantry US, Gurbel PA. Controversies in oral antiplatelet therapy in patients undergoing aortocoronary bypass surgery. Ann Thorac Surg 2010;90:1040-1051.
9. Vorobcsuk A, Aradi D, Farkasfalvi K, Horváth IG, Komócsi A. Outcomes of patients receiving clopidogrel prior to cardiac surgery. Int J Cardiol doi:10.1016/j.ijcard.2010.10.034. Published online ahead of print 26 November 2010.
10. Purkayastha S, Athanasiou T, Malinovski V, Tekkis P, Foale R, Casula R, Glenville B, Darzi A. Does clopidogrel affect outcome after coronary artery bypass grafting? A meta-analysis. Heart 2006;92:531-532.
11. Mehta RH, Roe MT, Mulgund J, Ohman EM, Cannon CP, Gibler WB, Pollack CV Jr, Smith SC Jr, Ferguson TB, Peterson ED. Acute clopidogrel use and outcomes in patients with non-ST-segment elevation acute coronary syndromes undergoing coronary artery bypass surgery. J Am Coll Cardiol 2006;48:281-286.
12. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.0.2 [updated Sept 2009]. The Cochrane Collaboration, 2009. Available from: www.cochrane-handbook.org.
13. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009;151:264-269.
14. Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB. Meta-analysis of observational studies in epidemiology: a proposal for reporting. JAMA 2000;283:2008-2012. (Pubitemid 30214957)
15. Athanasiou T, Aziz O, Mangoush O, Weerasinghe A, Al-Ruzzeh S, Purkayastha S, Pepper J, Amrani M, Glenville B, Casula R. Do off-pump techniques reduce the incidence of postoperative atrial fibrillation in elderly patients undergoing coronary artery bypass grafting? Ann Thorac Surg 2004;77:1567-1574. (Pubitemid 38529983)
16. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 2010;25: 603-605.
17. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986;7: 177-188. (Pubitemid 17189972)
18. Mantel N, Haenszel W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst 1959;22:719-748.
19. Vecht JA, Saso S, Rao C, Dimopoulos K, Grapsa J, Terracciano CM, Peters NS, Nihoyannopoulos P, Holmes E, Gatzoulis MA, Athanasiou T. Atrial septal defect closure is associated with a reduced prevalence of atrial tachyarrhythmia in the short to medium term: a systematic review and meta-analysis. Heart 2010;96:1789-1797.
20. Yende S, Wunderink RG. Effect of clopidogrel on bleeding after coronary artery bypass surgery. Crit Care Med 2001;29:2271-2275. (Pubitemid 34038157)
21. Hongo RH, Ley J, Dick SE, Yee RR. The effect of clopidogrel in combination with aspirin when given before coronary artery bypass grafting. J Am Coll Cardiol 2002; 40:231-237. (Pubitemid 34756281)
22. Gansera B, Schmidtler F, Spiliopoulos K, Angelis I, Neumaier-Prauser P, Kemkes BM. Urgent or emergent coronary revasularization using bilateral internal thoracic artery after previous clopidogrel antiplatelet therapy. Thorac Cardiovasc Surg 2003;51:185-189. (Pubitemid 37229331)
23. Ray JG, Deniz S, Olivieri A, Pollex E, Vermeulen MJ, Alexander KS, Cain DJ, Cybulsky I, Hamielec CM. Increased blood product use among coronary artery bypass patients prescribed preoperative aspirin and clopidogrel. BMC Cardiovasc Disord 2003;3:3-8.
24. Chen L, Bracey AW, Radovancevic R, Cooper JR Jr, Collard CD, Vaughn WK, Nussmeier NA. Clopidogrel and bleeding in patients undergoing elective coronary artery bypass grafting. J Thorac Cardiovasc Surg 2004;128:425-431. (Pubitemid 39194700)
25. Chu MW, Wilson SR, Novick RJ, Stitt LW, Quantz MA. Does clopidogrel increase blood loss following coronary artery bypass surgery? Ann Thorac Surg 2004;78: 1536-1541. (Pubitemid 39423508)
26. Englberger L, Faeh B, Berdat PA, Eberli F, Meier B, Carrel T. Impact of clopidogrel in coronary artery bypass grafting. Eur J Cardiothorac Surg 2004;26:96-101. (Pubitemid 38759931)
27. Fox KA, Mehta SR, Peters R, Zhao F, Lakkis N, Gersh BJ, Yusuf S. Benefits and risks of the combination of clopidogrel and aspirin in patients undergoing surgical revascularization for non-ST-elevation acute coronary syndrome: the Clopidogrel in Unstable angina to prevent Recurrent ischemic Events (CURE) trial. Circulation 2004;110:1202-1208. (Pubitemid 39202333)
28. Hekmat K, Menzel C, Kroener A, Schwinger RH, Kampe S, Fischer UM, Geissler HJ, Mehlhorn U. The effect of preoperative antiplatelet therapy in coronary artery surgery: blood transfusion requirements for patients on cardiopulmonary bypass. Curr Med Res Opin 2004;20:1429-1435. (Pubitemid 39361346)
29. Karabulut H, Toraman F, Evrenkaya S, Goksel O, Tarcan S, Alhan C. Clopidogrel does not increase bleeding and allogenic blood transfusion in coronary artery surgery. Eur J Cardiothorac Surg 2004;25:419-423. (Pubitemid 38340580)
30. Akowuah E, Shrivastava V, Jamnadas B, Hopkinson D, Sarkar P, Storey R, Braidley P, Cooper G. Comparison of two strategies for the management of antiplatelet therapy during urgent surgery. Ann Thorac Surg 2005;80:149-152. (Pubitemid 40840200)
31. Ascione R, Ghosh A, Rogers CA, Cohen A, Monk C, Angelini GD. In-hospital patients exposed to clopidogrel before coronary artery bypass graft surgery: a word of caution. Ann Thorac Surg 2005;79:1210-1216. (Pubitemid 40431840)
32. Kapetanakis EI, Medlam DA, Boyce SW, Haile E, Hill PC, Dullum MK, Bafi AS, Petro KR, Corso PJ. Clopidogrel administration prior to coronary artery bypass grafting surgery: the cardiologist's panacea or the surgeon's headache. Eur Heart J 2005;26:576-583. (Pubitemid 40461099)
33. Leong JY, Baker RA, Shah PJ, Cherian VK, Knight JL. Clopidogrel and bleeding after coronary artery bypass graft surgery. Ann Thorac Surg 2005;80:928-933. (Pubitemid 41196786)
34. Nurozler F, Kutlu T, Küçük G, Okten C. Impact of clopidogrel on postoperative blood loss after non-elective coronary bypass surgery. Interact Cardiovasc Thorac Surg 2005;4:546-549. (Pubitemid 41744455)
35. von Heymann C, Redlich U, Moritz M, Sander M, Vargas Hein O, Grubitzsch H, Konertz WF, Spies C. Aspirin and clopidogrel taken until 2 days prior to coronary artery bypass graft surgery is associated with increased postoperative drainage loss. Thorac Cardiovasc Surg 2005;53:341-345. (Pubitemid 41783569)
36. Ouattara A, Bouzguenda H, Le Manach Y, Léger P, Mercadier A, Leprince P, Bonnet N, Montalescot G, Riou B, Coriat P. Impact of aspirin with or without clopidogrel on postoperative bleeding and blood transfusion in coronary surgical patients treated prophylactically with a low-dose of aprotinin. Eur Heart J 2007; 28:1025-1032. (Pubitemid 47343913)
37. Picker SM, Kaleta T, Hekmat K, Kampe S, Gathof BS. Antiplatelet therapy preceding coronary artery surgery: implications for bleeding, transfusion requirements and outcome. Eur J Anaesthesiol 2007;24:332-339.
38. Shim JK, Choi YS, Oh YJ, Bang SO, Yoo KJ, Kwak YL. Effects of preoperative aspirin and clopidogrel therapy on perioperative blood loss and blood transfusion requirements in patients undergoing off-pump coronary artery bypass graft surgery. Thorac Cardiovasc Surg 2007;134:59-64. (Pubitemid 46962043)
39. Kang W, Theman TE, Reed JF 3rd, Stoltzfus J, Weger NJ. The effect of preoperative clopidogrel on bleeding after coronary artery bypass surgery. Surg Educ 2007; 64:88-92. (Pubitemid 46488891)
40. McLean DS, Sabatine MS, Guo W, McCabe CH, Cannon CP. Benefits and risks of clopidogrel pretreatment before coronary artery bypass grafting in patients with ST-elevation myocardial infarction treated with fibrinolytics in CLARITY-TIMI 28. J Thromb Thrombolysis 2007;24:85-91.
41. Filsoufi F, Rahmanian PB, Castillo JG, Kahn RA, Fischer G, Adams DH. Clopidogrel treatment before coronary artery bypass graft surgery increases postoperative morbidity and blood product requirements. J Cardiothorac Vasc Anesth 2008;22: 60-66.
42. Maltais S, Perrault LP, Do QB. Effect of clopidogrel on bleeding and transfusions after off-pump coronary artery bypass graft surgery: impact of discontinuation prior to surgery. Eur J Cardiothorac Surg 2008;34:127-131.
43. Song SW, Youn YN, Yi G, Lee S, Yoo KJ. Effects of continuous administration of clopidogrel before off-pump coronary artery bypass grafting in patients with acute coronary syndrome. Circ J 2008;72:626-632. (Pubitemid 351679417)
44. Blasco-Colmenares E, Perl TM, Guallar E, Baumgartner WA, Conte JV, Alejo D, Pastor-Barriuso R, Sharrett AR, Faraday N. Aspirin plus clopidogrel and risk of infection after coronary artery bypass surgery. Arch Intern Med 2009;169: 788-796.
45. Ebrahimi R, Dyke C, Mehran R, Manoukian SV, Feit F, Cox DA, Gersh BJ, Ohman EM, White HD, Moses JW, Ware JH, Lincoff AM, Stone GW. Outcomes following pre-operative clopidogrel administration in patients with acute coronary syndromes undergoing coronary artery bypass surgery: the ACUITY (Acute Catheterization and Urgent Intervention Triage strategY) trial. J Am Coll Cardiol 2009;53:1965-1972.
46. Firanescu CE, Martens EJ, Schonberger JP, Soliman Hamad MA, van Straten AH. Postoperative blood loss in patients undergoing coronary artery bypass surgery after preoperative treatment with clopidogrel. A prospective randomised controlled study. Eur J Cardio-Thorac Surg 2009;36:856-862.
47. Vaccarino GN, Thierer J, Albertal M, Vrancic M, Piccinini F, Benzadón M, Raich H, Navia DO. Impact of preoperative clopidogrel in off pump coronary artery bypass surgery: a propensity score analysis. J Thorac Cardiovasc Surg 2009;137:309-313.
48. Nesher N, Singh SK, Fawzy HF, Sever JY, Goldman BE, Cohen GN, Laflamme C, Fremes SE. Impact of clopidogrel use on mortality and major bleeding in patients undergoing coronary artery bypass surgery. Interact Cardiovasc Thorac Surg 2010; 10:732-736.
49. Badreldin A, Kroener A, Kamiya H, Lichtenberg A, Hekmat K. Effect of clopidogrel on perioperative blood loss and transfusion in coronary artery bypass graft surgery. Interact Cardiovasc Thorac Surg 2010;10:48-52.
50. Herman CR, Buth KJ, Kent BA, Hirsch GM. Clopidogrel increases blood transfusion and hemorrhagic complications in patients undergoing cardiac surgery. Ann Thorac Surg 2010;89:397-402.
51. Dasarathan C, Vaidyanathan K, Chandrasekaran D, Cherian KM. Does preoperative clopidogrel increase bleeding after coronary bypass surgery? Asian Cardiovasc Thorac Ann 2011;19:52-56.
52. Held C, Asenblad N, Bassand JP, Becker RC, Cannon CP, Claeys MJ, Harrington RA, Horrow J, Husted S, James SK, Mahaffey KW, Nicolau JC, Scirica BM, Storey RF, Vintila M, Ycas J, Wallentin L. Ticagrelor versus clopidogrel in patients with acute coronary syndromes undergoing coronary artery bypass surgery: results from the PLATO (Platelet Inhibition and Patient Outcomes) trial. J Am Coll Cardiol 2011;57:672-684.
53. Wiviott SD, Braunwald E, McCabe CH, Montalescot G, Ruzyllo W, Gottlieb S, Neumann FJ, Ardissino D, De Servi S, Murphy SA, Riesmeyer J, Weerakkody G, Gibson CM, Antman EM; TRITON-TIMI 38 Investigators. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2007;357:2001-2015. (Pubitemid 350106708)
54. Bybee KA, Powell BD, Valeti U, Rosales AG, Kopecky SL, Mullany C, Wright RS. Preoperative aspirin therapy is associated with improved postoperative outcomes in patients undergoing coronary artery bypass grafting. Circulation 2005;112: I286-I292. (Pubitemid 41266689)
55. Cruden NL, Morch K, Wong DR, Klinke WP, Ofiesh J, Hilton JD. Clopidogrel loading dose and bleeding outcomes in patients undergoing urgent coronary artery bypass grafting. Am Heart J 2011;161:404-410.
56. Moulton MJ, Creswell LL, Mackey ME, Cox JL, Rosenbloom M. Reexploration for bleeding is a risk factor for adverse outcomes after cardiac operations. J Thorac Cardiovasc Surg 1996;111:1037-1046. (Pubitemid 26146058)
57. Mangano DT; Multicenter Study of Perioperative Ischemia Research Group. Aspirin and mortality from coronary bypass surgery. N Engl J Med 2002;347: 1309-1317. (Pubitemid 35215321)
58. Alghamdi AA, Moussa F, Fremes SE. Does the use of preoperative aspirin increase the risk of bleeding in patients undergoing coronary artery bypass grafting surgery? Systematic review and meta-analysis. J Card Surg 2007;22:247-256. (Pubitemid 46683959)
59. Raja SG, Dreyfus GD. Impact of off-pump coronary artery bypass surgery on postoperative bleeding: current best available evidence. J Card Surg 2006;21: 35-41.
60. Murphy GJ, Reeves BC, Rogers CA, Rizvi SI, Culliford L, Angelini GD. Increased mortality, postoperative morbidity, and cost after red blood cell transfusion in patients having cardiac surgery. Circulation 2007;116:2544-2552. (Pubitemid 350179219)
61. Øvrum E, Tangen G, Tølløfsrud S, Ringdal MA, Øystese R, Istad R. Low postoperative dose of aprotinin reduces bleeding and is safe in patients receiving clopidogrel before coronary artery bypass surgery. A prospective randomized study. Interact Cardiovasc Thorac Surg 2010;10:545-548.
62. Kim JH, Newby LK, Clare RM, Shaw LK, Lodge AJ, Smith PK, Jolicoeur EM, Rao SV, Becker RC, Mark DB, Granger CB. Clopidogrel use and bleeding after coronary artery bypass surgery. Am Heart J 2008;156:886-892.
63. NHS Heart Improvement. Cardiac Surgery Commissioning Guide, NHS Document. http://www.improvement.nhs.uk/heart/Portals/0/documents2010/Cardiac-Surgery- Commissioning-Guide.pdf (4 January 2011).
64. Sambu N, Warner T, Curzen N. Clopidogrel withdrawal: is there a 'rebound' phenomenon? Thromb Haemost 2010;105 [Epub ahead of print].
65. Collet JP, Montalescot G, Blanchet B, Tanguy ML, Golmard JL, Choussat R, Beygui F, Payot L, Vignolles N, Metzger JP. Impact of prior use or recent withdrawal of oral antiplatelet agents on acute coronary syndromes. Circulation 2004;110: 2361-2367. (Pubitemid 39407340)
66. Gao G, Zheng Z, Pi Y, Lu B, Lu J, Hu S. Aspirin plus clopidogrel therapy increases early venous graft patency after coronary artery bypass surgery a single-center, randomized, controlled trial. J Am Coll Cardiol 2010;56:1639-1643.
67. Sun JC, Teoh KH, Lamy A, Sheth T, Ellins ML, Jung H, Yusuf S, Anand S, Connolly S, Whitlock RP, Eikelboom JW. Randomized trial of aspirin and clopidogrel versus aspirin alone for the prevention of coronary artery bypass graft occlusion: the Preoperative Aspirin and Postoperative Antiplatelets in Coronary Artery Bypass Grafting study. Am Heart J 2010;160:1178-1184.
68. Kwak YL, Kim JC, Choi YS, Yoo KJ, Song Y, Shim JK. Clopidogrel responsiveness regardless of the discontinuation date predicts increased blood loss and transfusion requirement after off-pump coronary artery bypass graft surgery. J Am Coll Cardiol 2010;56:1994-2002.
69. Mengistu AM, Mayer J, Boldt J, Röhm KD, Suttner SW. Usefulness of monitoring platelet function by multiple electrode aggregometry in primary coronary artery bypass surgery. J Cardiothorac Vasc Anesth 2011;25:42-47.
70. Preisman S, Kogan A, Itzkovsky K, Leikin G, Raanani E. Modified thromboelastography evaluation of platelet dysfunction in patients undergoing coronary artery surgery. Eur J Cardiothorac Surg 2010;37:1367-1374.
71. Wallentin L, James S, Storey RF, Armstrong M, Barratt BJ, Horrow J, Husted S, Katus H, Steg PG, Shah SH, Becker RC; PLATO investigators. Effect of CYP2C19 and ABCB1 single nucleotide polymorphisms on outcomes of treatment with ticagrelor versus clopidogrel for acute coronary syndromes: a genetic substudy of the PLATO trial. Lancet 2010;376:1320-1328.
72. Montalescot G, Wiviott SD, Braunwald E, Murphy SA, Gibson CM, McCabe CH, Antman EM; TRITON-TIMI 38 investigators. Prasugrel compared with clopidogrel in patients undergoing percutaneous coronary intervention for ST-elevation myocardial infarction (TRITON-TIMI 38): double-blind, randomised controlled trial. Lancet 2009;373:723-731.
73. Schneider DJ. Mechanisms potentially contributing to the reduction in mortality associated with ticagrelor therapy. J Am Coll Cardiol 2011;57: 685-687.
74. Clinical Trials.gov. Protocol NCT00767507. Maintenance of platelet inhibition with cangrelor (BRIDGE). http://www.clinicaltrials.gov/ct2/show/ NCT00767507 (19 Dec 2010).
75. Abualsaud AO, Eisenberg MJ. Perioperative management of patients with drug-eluting stents. JACC Cardiovasc Interv 2010;3:131-42.