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Patients may not have to stop taking anti-platelets for some surgeries
Date:12/10/2010

Despite the common clinical practice among surgeons to discontinue their patients' anti-platelet therapy prior to surgery, a recent study of patients undergoing carotid endarterectomy (CEA) indicated that this practice may be unnecessary. The study will be published in the December issue of the Annals of Vascular Surgery.

The use of clopidogrel (Plavix, Bristol-Myers Squibb/Sanofi-Aventis), an antiplatelet agent prescribed for patients with acute myocardial infarction (severe heart attack), recent stroke or peripheral arterial disease, continues to rise with U.S. sales of $3.9 billion in 2007, wrote the authors. As a result, the researchers sought to examine outcomes related to antiplatelet therapy in patients undergoing CEA, which is a surgical procedure that removes plaque from the carotid arteries in the neck to prevent stroke.

"Most surgeons choose to discontinue their patients' use of anti-platelets prior to surgery, despite the lack of scientific evidence," said study author Adnan Z. Rizvi, MD, from the department of vascular and endovascular surgery at the Minneapolis Heart Institute at Abbott Northwestern Hospital in Minneapolis. "However, studies have found increased bleeding with patients taking Plavix during open-heart surgery, so this surgery is an exception to our findings."

"In our practice, we previously stopped Plavix use prior to CEA. Yet, more recently, we have allowed some of our patients to continue with their anti-platelet therapy before undergoing CEA," explained Rizvi. "We decided to undertake this study to assess whether there were any higher bleeding complications associated with this decision."

For the study, five board-certified vascular surgeons retrospectively analyzed 260 consecutive patients who underwent CEA at the Minneapolis Heart Institute performed by between June 2006 and April 2009. Fifty of these patients were taking clopidogrel during surgery, were compared with nine patients who
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Contact: Meghan Bethke
mbethke@mhif.org
612-863-5410
Minneapolis Heart Institute Foundation
Source:Eurekalert

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