The potential influence of microthrombosis involving platelets has been underrecognized and, thus, the use of perioperative antiplatelet therapy continues to be very limited due to fear of bleeding, investigators concluded after conducting a recent review. The authors addressed the role of platelets in perioperative ischemic complications involving the brain, kidneys, and gastrointestinal tract, and long-term survival in patients undergoing coronary artery bypass grafting surgery. They looked at clinical studies where platelet activation and leukocyte inflammatory responses were found to be important mediators of vascular microthrombosis and ischemic injury. They found that, in some patients, the hemostatic balance during and after surgery may shift toward a hypercoagulable state and contribute to acute organ failure.
Raso Vasquez A, Kertai M, Fontes M. Postoperative thrombocytopenia: Why you should consider antiplatelet therapy? Curr Opin Anaesthesiol. 2018;31(1):61-66. doi:10.1097/ACO.0000000000000551.