The Particulars: Previous studies indicate that perioperative administration of aspirin varies substantially among patients undergoing non-cardiac surgery, both in patients already on an aspirin regimen and those who are not.
Data Breakdown: For a study, more than 10,000 patients scheduled for non-cardiac surgery and at risk for vascular complications were randomized to receive aspirin or placebo. Participants took aspirin (200 mg) or placebo just before surgery and continued it at a dose of 100 mg for 30 days in the initiation stratum and for 7 days in the continuation stratum, after with patients resumed their regular aspirin regimen. Rates of a composite of death or non-fatal myocardial infarction at 30 days were similar in the aspirin and placebo groups (7.0% vs 7.1%, respectively). Major bleeding was more common in the aspirin group (4.6%) than the placebo group (3.8%).
Take Home Pearls: Administration of aspirin pre-surgically and throughout the early postsurgical period appears to have no significant effect on rates of mortality or non-fatal myocardial infarction when compared with placebo. However, aspirin appears to increase major bleeding risk when compared with placebo.