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Please use this identifier to cite or link to this item: https://hdl.handle.net/11055/601
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dc.contributor.authorMyles, PSen_US
dc.contributor.authorSmith, JAen_US
dc.contributor.authorForbes, Aen_US
dc.contributor.authorSilbert, Ben_US
dc.contributor.authorJayarajah, Men_US
dc.contributor.authorPainter, Ten_US
dc.contributor.authorCooper, DJen_US
dc.contributor.authorMarasco, Sen_US
dc.contributor.authorMcNeil, Jen_US
dc.contributor.authorBussières, JSen_US
dc.contributor.authorWallace, Sen_US
dc.contributor.authorATACAS Investigators of the ANZCA Clinical Trials Networken_US
dc.date.accessioned2018-06-20T03:33:58Z-
dc.date.available2018-06-20T03:33:58Z-
dc.date.issued2016-02-
dc.identifier.citation25;374(8):728-37.en_US
dc.identifier.urihttp://hdl.handle.net/11055/601-
dc.description.abstractBACKGROUND: Most patients with coronary artery disease receive aspirin for primary or secondary prevention of myocardial infarction, stroke, and death. Aspirin poses a risk of bleeding in patients undergoing surgery, but it is unclear whether aspirin should be stopped before coronary artery surgery. METHODS: We used a 2-by-2 factorial trial design to randomly assign patients who were scheduled to undergo coronary artery surgery and were at risk for perioperative complications to receive aspirin or placebo and tranexamic acid or placebo. The results of the aspirin trial are reported here. Patients were randomly assigned to receive 100 mg of aspirin or matched placebo preoperatively. The primary outcome was a composite of death and thrombotic complications (nonfatal myocardial infarction, stroke, pulmonary embolism, renal failure, or bowel infarction) within 30 days after surgery. RESULTS: Among 5784 eligible patients, 2100 were enrolled; 1047 were randomly assigned to receive aspirin and 1053 to receive placebo. A primary outcome event occurred in 202 patients in the aspirin group (19.3%) and in 215 patients in the placebo group (20.4%) (relative risk, 0.94; 95% confidence interval, 0.80 to 1.12; P=0.55). Major hemorrhage leading to reoperation occurred in 1.8% of patients in the aspirin group and in 2.1% of patients in the placebo group (P=0.75), and cardiac tamponade occurred at rates of 1.1% and 0.4%, respectively (P=0.08). CONCLUSIONS: Among patients undergoing coronary artery surgery, the administration of preoperative aspirin resulted in neither a lower risk of death or thrombotic complications nor a higher risk of bleeding than that with placebo. (Funded by the Australian National Health and Medical Research Council and others; Australia New Zealand Clinical Trials Registry number, ACTRN12605000557639.).en_US
dc.titleStopping vs. Continuing Aspirin before Coronary Artery Surgeryen_US
dc.typeJournal Articleen_US
dc.type.contentTexten_US
dc.identifier.journaltitleNew England Journal of Medicineen_US
dc.identifier.doi10.1056/NEJMoa1507688.en_US
dc.description.affiliatesThe Alfred Hospitalen_US
dc.description.pubmedurihttps://www.ncbi.nlm.nih.gov/pubmed/26933848en_US
dc.type.studyortrialClinical Trialen_US
dc.identifier.studynameACTRN12605000557639: The ATACAS Trial: Aspirin and Tranexamic Acid for Coronary Artery Surgery Trialen_US
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.cerifentitytypePublications-
item.openairetypeJournal Article-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
Appears in Collections:Scholarly and Clinical
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