Surgery Clinical Trial
Official title:
Discontinuation of Low-dose Acetylsalicylic Acid Before Elective Non-cardiac Surgery: a Preoperative Monocentric Cross-sectional Study
This study aims to assess independent factors associated with the clinical decision to discontinue ASA preoperatively in patients undergoing elective non-cardiac surgery.
Acetylsalicylic acid (ASA) is widely used for primary and secondary prevention of
cardiovascular diseases. A prothrombotic rebound phenomenon after aspirin cessation has been
reported. ASA withdrawal is associated with an increased incidence of adverse cardiac
events. In individuals with previous percutaneous coronary intervention (PCI), cessation of
ASA may cause stent thrombosis or myocardial infarction. However, many patients undergo
non-cardiac surgery within the first two years after PCI. Perioperatively, two counteracting
risks have to be taken into account, first, the risk of thromboembolic complications, if ASA
medication is discontinued and second, the risk of surgical bleeding, if ASA therapy is
continued. However, factors contributing to preoperative decision-making for ASA-withdrawal
are still unclear.
This study aims to assess independent factors associated with the clinical decision to
discontinue ASA preoperatively in patients undergoing elective non-cardiac surgery. In
particular this study aims to determine if the presence of coronary stents is independently
associated with ASA discontinuation. Furthermore this study assesses, if
benefit-risk-estimates (numerical rating scales) of the patients and the supervising
physicians are associated with the decision to withdraw ASA.
Study design
Patients on long-term ASA undergoing non-cardiac surgery as well as their supervising
anesthesiologist participate in a preoperative survey. Detailed information about ASA
medication, perioperative ASA use, comorbidities, factors that might be associated with the
decision to discontinue ASA preoperatively and benefit-risk-estimates (numerical rating
scales) are sampled by questionnaires.
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