Preoperative Ticagrelor administration leads to a higher risk of XXXX during and after coronary bypass surgery in a case-matched analysis.

@entity1 @entity548 @entity190 @entity1397 @entity117 @entity260 @entity86 @entity7943
OBJECTIVES: To evaluate the effect of Ticagrelor on intra- and @entity260 in @entity1 undergoing coronary bypass surgery. METHODS: For this study, @entity1 who underwent on-pump or off-pump coronary bypass surgery with preoperative @entity117 ( @entity7943 ) and Ticagrelor administration, between January 2014 and December 2014, were included. In the matched control group, continued dual antiplatelet therapy (DAPT) consisted of @entity1397 and @entity7943 . A total of 28 consecutive @entity1 (24 males; 73    6.6 years) with preoperative Ticagrelor intake underwent elective (n = 22), urgent (n = 2) or emergency (n = 4) cardiac bypass surgery. The @entity86 , red blood cell units given and intra- and @entity260 were documented. To evaluate the effect of Ticagrelor treatment on @entity548 during and after coronary bypass surgery in a non-randomized study, we used a case-matched analysis. RESULTS: Baseline parameters showed no important differences between the study group and the control group regarding the matching variables, left ventricular function, preoperative clinical status and risk stratification. The preoperative laboratory analysis showed no important differences regarding coagulation and blood cell count parameters. Overall @entity190 was significantly higher in the study group with a mean loss of 1028.8    735.5 ml (P = 0.0002). Accordingly, units of red blood cells administered were also significantly higher in the study group (P = 0.0002). In the Ticagrelor group, there were six rethoracotomies due to @entity86 with a @entity190 of more than 1200 ml in the first 3 h. With no rethoracotomies in the @entity1397 group, this also showed statistical significance for the postoperative course (P = 0.02). There were no differences found regarding ICU stay and ventilation time. Comparing the mean hospital stay, the study group presented a significantly longer stay than the control group (P = 0.001). CONCLUSIONS: Recent studies about @entity548 complications in @entity1 with Ticagrelor intake undergoing CABG in a real-life scenario presented inconsistent data. We were able to show in a case-matched analysis that Ticagrelor administration leads to significantly higher @entity190 , more red blood cell units transfused and a higher rate of rethoracotomies. The data also present a longer hospital stay to the disadvantage of the study group. Consequently, Ticagrelor intake before CABG procedures should be avoided or at least discontinued 3 days before cardiac surgery.
