Clopidogrel Poses Little Bleeding Risk During Thoracic Surgery
Major Finding: Thirty-three patients who underwent thoracic surgery while on dual antiplatelet therapy with clopidogrel and aspirin generally had no increased bleeding risk, compared with thoracic surgery patients withdrawn from these drugs.
Data Source: Prospective, consecutive series of 33 patients at one U.S. center during January 2009-April 2010 who represented the full range of thoracic surgery procedures.
Disclosures: Dr. Cerfolio said that he and his associates had no relevant disclosures.
Additional subgroup analysis focused on the 8 cases and 14 controls who underwent lung lobectomy. In these patients, none of the 8 lobectomy cases with a coronary stent kept on clopidogrel and aspirin during surgery had a major coronary event, but 5 of the 14 controls (36%) with a coronary stent withdrawn from clopidogrel and aspirin had a major coronary event, a difference that reached statistical significance.
Although this final subgroup analysis included a very small number of patients, the significant difference in adverse events suggested the importance of maintaining clopidogrel treatment during thoracic surgery, especially in patients with coronary stents, he concluded.
Dr. Cerfolio said that he and his associates had no relevant disclosures.
Robert J. Cerfolio
