Aspirin dosage for the prevention of graft occlusion in people undergoing coronary surgery: a systematic review and meta-analysis

Background: Aspirin is almost always used after coronary artery bypass graft (CABG) surgery; however, it is unclear what optimal dose should be prescribed. In this systematic review, we evaluated the effects of high versus low-dose aspirin in patients after CABG. Methods: A comprehensive database se...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Fares Alahdab, Ruba Zuhri Yafi, Abdelkader Chaar, Ali Alrstom, Muayad Alzuabi, Omar Alhalabi, Somar Hasan, Mahmoud Mallak, Mohamad Luay Jazayerli, Qusay Haydour, Mohamad Alkhouli, Wedad Alfarkh, Mohammad Hassan Murad
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2020
Materias:	aspirin atherosclerosis coronary artery bypass graft myocardial infarction review systematic review Medicine R
Acceso en línea:	https://doaj.org/article/368cda6251b64b37b9f681238f3fba2c
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:368cda6251b64b37b9f681238f3fba2c
record_format	dspace
spelling	oai:doaj.org-article:368cda6251b64b37b9f681238f3fba2c2021-12-02T18:42:19ZAspirin dosage for the prevention of graft occlusion in people undergoing coronary surgery: a systematic review and meta-analysis2231-07702249-446410.4103/ajm.ajm_17_20https://doaj.org/article/368cda6251b64b37b9f681238f3fba2c2020-10-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.4103/ajm.ajm_17_20https://doaj.org/toc/2231-0770https://doaj.org/toc/2249-4464Background: Aspirin is almost always used after coronary artery bypass graft (CABG) surgery; however, it is unclear what optimal dose should be prescribed. In this systematic review, we evaluated the effects of high versus low-dose aspirin in patients after CABG. Methods: A comprehensive database search was conducted in several databases from date of inception until February 2018. There were no language restrictions. We included studies that compared different doses of aspirin in patients that had undergone CABG surgery. We included studies that evaluated patient-important outcomes (mortality, cardiovascular events, and gastrointestinal bleeding); and if not reported, we collected data on the surrogate outcome thromboxane B2 (TXB2). We collected relevant data and performed a meta-analysis. Results: We identified 5903 references, and after two levels of screening by two independent reviewers, we included three randomized controlled trials in the meta-analysis with a total number of 122 participants. Mean age of trial participants was 65.63 years, and 88.68% were male. We planned to analyze all possible clinical outcomes, including mortality, recurrence, and hospitalization. However, no clinical outcomes are reported by the literature. The surrogate biochemical outcome of serum TXB2 was the only outcome reported by the eligible studies. High-dose aspirin (162–325 mg once daily) achieved better suppression of TXB2 than low-dose aspirin (75–100 mg once daily) (mean difference [MD], 2.00ng/mL, 95% confidence interval [CI]: 0.72–3.32; participants = 122; studies = 3; I2 = 0%). Conclusions: We found no clinical trials addressing any of the clinical outcomes of interest. High-dose aspirin was superior to low-dose aspirin in suppressing platelet function, a surrogate outcome. Trials evaluating clinical and patient-important outcomes are needed to better inform medical practice and fill this gap in clinical knowledge.Fares AlahdabRuba Zuhri YafiAbdelkader ChaarAli AlrstomMuayad AlzuabiOmar AlhalabiSomar HasanMahmoud MallakMohamad Luay JazayerliQusay HaydourMohamad AlkhouliWedad AlfarkhMohammad Hassan MuradThieme Medical and Scientific Publishers Pvt. Ltd.articleaspirinatherosclerosiscoronary artery bypass graftmyocardial infarctionreviewsystematic reviewMedicineRENAvicenna Journal of Medicine, Vol 10, Iss 04, Pp 198-207 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	aspirin atherosclerosis coronary artery bypass graft myocardial infarction review systematic review Medicine R
spellingShingle	aspirin atherosclerosis coronary artery bypass graft myocardial infarction review systematic review Medicine R Fares Alahdab Ruba Zuhri Yafi Abdelkader Chaar Ali Alrstom Muayad Alzuabi Omar Alhalabi Somar Hasan Mahmoud Mallak Mohamad Luay Jazayerli Qusay Haydour Mohamad Alkhouli Wedad Alfarkh Mohammad Hassan Murad Aspirin dosage for the prevention of graft occlusion in people undergoing coronary surgery: a systematic review and meta-analysis
description	Background: Aspirin is almost always used after coronary artery bypass graft (CABG) surgery; however, it is unclear what optimal dose should be prescribed. In this systematic review, we evaluated the effects of high versus low-dose aspirin in patients after CABG. Methods: A comprehensive database search was conducted in several databases from date of inception until February 2018. There were no language restrictions. We included studies that compared different doses of aspirin in patients that had undergone CABG surgery. We included studies that evaluated patient-important outcomes (mortality, cardiovascular events, and gastrointestinal bleeding); and if not reported, we collected data on the surrogate outcome thromboxane B2 (TXB2). We collected relevant data and performed a meta-analysis. Results: We identified 5903 references, and after two levels of screening by two independent reviewers, we included three randomized controlled trials in the meta-analysis with a total number of 122 participants. Mean age of trial participants was 65.63 years, and 88.68% were male. We planned to analyze all possible clinical outcomes, including mortality, recurrence, and hospitalization. However, no clinical outcomes are reported by the literature. The surrogate biochemical outcome of serum TXB2 was the only outcome reported by the eligible studies. High-dose aspirin (162–325 mg once daily) achieved better suppression of TXB2 than low-dose aspirin (75–100 mg once daily) (mean difference [MD], 2.00ng/mL, 95% confidence interval [CI]: 0.72–3.32; participants = 122; studies = 3; I2 = 0%). Conclusions: We found no clinical trials addressing any of the clinical outcomes of interest. High-dose aspirin was superior to low-dose aspirin in suppressing platelet function, a surrogate outcome. Trials evaluating clinical and patient-important outcomes are needed to better inform medical practice and fill this gap in clinical knowledge.
format	article
author	Fares Alahdab Ruba Zuhri Yafi Abdelkader Chaar Ali Alrstom Muayad Alzuabi Omar Alhalabi Somar Hasan Mahmoud Mallak Mohamad Luay Jazayerli Qusay Haydour Mohamad Alkhouli Wedad Alfarkh Mohammad Hassan Murad
author_facet	Fares Alahdab Ruba Zuhri Yafi Abdelkader Chaar Ali Alrstom Muayad Alzuabi Omar Alhalabi Somar Hasan Mahmoud Mallak Mohamad Luay Jazayerli Qusay Haydour Mohamad Alkhouli Wedad Alfarkh Mohammad Hassan Murad
author_sort	Fares Alahdab
title	Aspirin dosage for the prevention of graft occlusion in people undergoing coronary surgery: a systematic review and meta-analysis
title_short	Aspirin dosage for the prevention of graft occlusion in people undergoing coronary surgery: a systematic review and meta-analysis
title_full	Aspirin dosage for the prevention of graft occlusion in people undergoing coronary surgery: a systematic review and meta-analysis
title_fullStr	Aspirin dosage for the prevention of graft occlusion in people undergoing coronary surgery: a systematic review and meta-analysis
title_full_unstemmed	Aspirin dosage for the prevention of graft occlusion in people undergoing coronary surgery: a systematic review and meta-analysis
title_sort	aspirin dosage for the prevention of graft occlusion in people undergoing coronary surgery: a systematic review and meta-analysis
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2020
url	https://doaj.org/article/368cda6251b64b37b9f681238f3fba2c
work_keys_str_mv	AT faresalahdab aspirindosageforthepreventionofgraftocclusioninpeopleundergoingcoronarysurgeryasystematicreviewandmetaanalysis AT rubazuhriyafi aspirindosageforthepreventionofgraftocclusioninpeopleundergoingcoronarysurgeryasystematicreviewandmetaanalysis AT abdelkaderchaar aspirindosageforthepreventionofgraftocclusioninpeopleundergoingcoronarysurgeryasystematicreviewandmetaanalysis AT alialrstom aspirindosageforthepreventionofgraftocclusioninpeopleundergoingcoronarysurgeryasystematicreviewandmetaanalysis AT muayadalzuabi aspirindosageforthepreventionofgraftocclusioninpeopleundergoingcoronarysurgeryasystematicreviewandmetaanalysis AT omaralhalabi aspirindosageforthepreventionofgraftocclusioninpeopleundergoingcoronarysurgeryasystematicreviewandmetaanalysis AT somarhasan aspirindosageforthepreventionofgraftocclusioninpeopleundergoingcoronarysurgeryasystematicreviewandmetaanalysis AT mahmoudmallak aspirindosageforthepreventionofgraftocclusioninpeopleundergoingcoronarysurgeryasystematicreviewandmetaanalysis AT mohamadluayjazayerli aspirindosageforthepreventionofgraftocclusioninpeopleundergoingcoronarysurgeryasystematicreviewandmetaanalysis AT qusayhaydour aspirindosageforthepreventionofgraftocclusioninpeopleundergoingcoronarysurgeryasystematicreviewandmetaanalysis AT mohamadalkhouli aspirindosageforthepreventionofgraftocclusioninpeopleundergoingcoronarysurgeryasystematicreviewandmetaanalysis AT wedadalfarkh aspirindosageforthepreventionofgraftocclusioninpeopleundergoingcoronarysurgeryasystematicreviewandmetaanalysis AT mohammadhassanmurad aspirindosageforthepreventionofgraftocclusioninpeopleundergoingcoronarysurgeryasystematicreviewandmetaanalysis
_version_	1718377732038983680

Aspirin dosage for the prevention of graft occlusion in people undergoing coronary surgery: a systematic review and meta-analysis

Ejemplares similares