Effects of preoperative enoxaparin versus unfractionated heparin on bleeding indices in patients undergoing coronary artery bypass grafting

Kincaid, Edward H.; Monroe, Michelle L; Saliba, David L; Kon, Neal D.; Byerly, Wesley G.; Reichert, Marc G.

doi:10.1016/s0003-4975(03)00190-5

Cited by 56 publications

(16 citation statements)

References 15 publications

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“…Given the poor short-term prognosis of those with these arrhythmias, mechanical and ischemic causes should be considered in the postoperative setting. 277 With widespread stent use as well as effective antiplatelet and antithrombotic therapies, emergency CABG after failed PCI is not commonly performed. In a 2009 analysis of data from almost 22 000 patients undergoing PCI at a single center, only 90 (0.4%) required CABG within 24 hours of PCI.…”

Section: Emergencymentioning

confidence: 99%

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

et al. 2011

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Section: Emergencymentioning

confidence: 99%

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

et al. 2011

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“…(Level of Evidence: B)2. Discontinue enoxaparin 12 to 24 hours before CABG and dose with UFH per institutional practice(80,(92)(93)(94).…”

mentioning

confidence: 99%

2012 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction (Updating the 2007 Guideline and Replacing the 2011 Focused Update)

Jneid¹,

Anderson²,

Wright³

et al. 2012

Journal of the American College of Cardiology

502

276

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“…Unfractioned or low molecular weight heparin, at any time in the preoperative period, did not influence the bleeding. KINCAID et al [24] found greater bleeding in patients who received low molecular weight heparin less than 12 hours before surgery; a fact that must be related to the anti-Xa effect, with a peak action at 12 hours in 30% of the cases, in spite of having a half-life of from 5 to 6 hours.…”

Section: Commentsmentioning

confidence: 99%

Fatores de risco de sangramento no pós-operatório de cirurgia cardíaca em pacientes adultos

Miana¹,

Atik²,

Moreira³

et al. 2004

Rev Bras Cir Cardiovasc

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Objective: To determine predictors of postoperative bleeding after cardiac surgery, in order to focus on preventive measures for high-risk populations.Methods: From October 2001 to March 2002, 411 consecutive adult cardiac surgery patients were prospectively studied, with the exception of those submitted to heart transplantation. In order to determine risk factors for postoperative bleeding, 20 preoperative, 17 operative and 6 postoperative variables were analyzed using univariate methods and multiple linear regression.Results: Operative procedures included coronary artery bypass grafting in 227 (55.2%) patients, valvar operations in 198 (48.2%), aortic surgery in 25 (6.1%) and combined procedures in 60 (14.6%). Cardiopulmonary bypass was used in 335 (81.5%) patients and anti-fibrinolysis agents in 148 (36%). The thirty-day mortality rate was 5.6% (23 patients). Mean 24-hour postoperative blood loss was 610 ± 500 mL (range 10-4900). Re-exploration for bleeding was required in 15 (3.7%) patients. Independent predictors of postoperative bleeding were emergency operations (p=0.049), postoperative metabolic acidosis (p=0.001), preoperative thrombocytopenia (p=0.034) and prolonged cardiopulmonary bypass (p=0.021).Conclusions: When possible, preoperative stabilization and correction of coagulation disturbances should be achieved in patients requiring urgent or emergent surgery and in those with thrombocytopenia. The duration of cardiopulmonary bypass should be minimized as long as this is practical. Postoperative metabolic acidosis must be actively corrected, especially the main determining causes. Descriptors

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Effects of preoperative enoxaparin versus unfractionated heparin on bleeding indices in patients undergoing coronary artery bypass grafting

Cited by 56 publications

References 15 publications

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

2012 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction (Updating the 2007 Guideline and Replacing the 2011 Focused Update)

Fatores de risco de sangramento no pós-operatório de cirurgia cardíaca em pacientes adultos

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