In noncardiac surgery, perioperative aspirin did not reduce death or MI at 30 d but increased major bleeding

摘要

10 010 patients > 45 years of age (mean age 69 y, 53% men) who were having major vascular surgery, or other in-hospital noncardiac surgery with >= 1 of the following: coronary artery disease, peripheral artery disease, previous stroke, or > 3 of 9 risk criteria (age > 70 y, smoking < 2 y before surgery, congestive heart failure, hypertension, diabetes with use of oral hypoglycemic agents or insulin, previous transient ischemic attack, preoperative serum creatinine > 175 umol/L [> 2.0 mg/dL], emergent or urgent surgery, or major surgery). Patients using aspirin at enrollment had to stop the drug > 3 days before surgery. Intervention: Aspirin, 200 mg before surgery and 100 mg/d for 7 or 30 days after surgery (n = 4998), or placebo (n = 5012). Patients who were not using aspirin at enrollment continued treatment for 30 days; those using aspirin at enrollment stopped the study drug at 7 days and restarted their regular aspirin regimen. Patients were also randomized to clonidine or placebo.