Aspirin in patients undergoing noncardiac surgery
| Title: | Aspirin in patients undergoing noncardiac surgery |
|---|---|
| Authors: | Devereaux PJ; Mrkobrada M; Sessler DI; Leslie K; Alonso Coello P; Kurz A; Villar JC; Sigamani A; Biccard BM; Meyhoff CS; Parlow JL; Guyatt G; Robinson A; Garg AX; Rodseth RN; Botto F; Lurati Buse G; Xavier D; Chan MT; Tiboni M; Cook D; Kumar PA; Forget P; Malaga G; Fleischmann E; Amir M; Eikelboom J; Mizera R; Torres D; Wang CY; VanHelder T; Paniagua P; Berwanger O; Srinathan S; Graham M; Pasin L; Le Manach Y; Gao P; Pogue J; Whitlock R; Lamy A; Kearon C; Baigent C; Chow C; Pettit S; Chrolavicius S; Yusuf S; POISE 2 I.n.v.e.s.t.i.g.a.t.o.r.s. DeBeer J; Patel A; Dechert W; Jackson P; Allard R; Dumerton Shore D; McCourt J; Jones PM; Lavi R; Lavi S; Moor R; Dresser GK; Gros ML; Schumann VC; Baur M; MacDonald C; Wirzba B; Regalado O; Srinathan SK; Ong DD; Todd A; Abbas S; Beattie WS; Chan VW; Chin KJ; Wijeysundera DN; Graham MM; Irwin M; Jacka M; El Beheiry H; McMullen SM; MacDonald P; Akhtar Z; Ayad S; Buttar M; Deroee A; Eshraghi Y; Fergany A; Finnigan P; Fu A; Grady M; Helper S; Hesler B; Honar H; Hutcherson M; Krebs V; Lee J; Malik M; Podolyak A; Salmasi V; Arora H; Coombs RF; Martinelli SM; Bergese SD; Melibary SB; Uribe AA; Jordan M; Miller SA; Cata JP; Nemergut EC; Candiotti KA; Memtsoudis SG; McKay RE; Montes FR; Parra GA; Rojas MF; Plata R; Vásquez SM; Sarquis T; Haider Z; Jane NB; Lanjewar PP; Rahate PV; Mehra BR; Premendaran B; Abraham V; George P; Kumar P; Gaikwad SB; Mohan NV; Sidhu G; Alvarez J; Gonzalez R; Maestre M; Popova E; Urrutia G; de Nadal M; González Suárez S; González Tallada A; Plou P; Mena E; Riveira C; del Valle S; Tena B; Lang SA; Ludbrook GL; Painter TW; Terblanche NC; Osborne C; Mahood JR; Myles PS; Sivalingam P; Riedel B; Elhalawani I; Drummond L; Mugabi A; Naidoo P; Myburgh AL; Porrill OS; Diedericks BJ; Turton EW; Bøgeskov M; Dahl RM; Madsen MV; Søndergaard ES; Bauer NE; Martinsen KR; Choi GY; Gin T; Ng SS; Bidgoli SJ; Van der Linden PJ; De Kock M; Kabon B; Luf F; Radonic M; Ishtiaq O; Safdar J; Acuna Villaorduna A; Barrionuevo P; Castaneda Guarderas A; Caballero JA; Lau VE; Aphang Lam MR; Lembo R; Jara X; Leon P; Ong GS; Lee HS; Seeberger EE; Seeberger MD; Alfonsi P; Coriat P; Piriou V; Vizcaychipi MP; Rech RL; Bergo RR; Walker S; Rodseth R; LeManach Y; Díaz R; Cortés OL; Wetterslev J; Hoeft A; Wittmann M; Chan M; Landoni G; Conen D; Balaji P; Sovereign T; Blake L; Sephton J; Serra A; Agrippa C; Lawrence M; Biccard B; Gluud C; Karthikeyan G; Auerbach A; Beattie S; Buckley N; Douketis J; Gerstein H; Ghali W; Hart R; Hill M; McAlister F; McAuley D; Miller S; O'Donnell M; Pais P; Parlow J; Schricker T; Sessler D; Simunovic M; Teoh K; Walsh M; Wijeysundera D; Yang H; Alshalash S; Bessissow A; Duceppe E; Khalid Z; Khan J; Lauw M; Martinsen K; Neary J; Oczkowski W; Papina M; Seeberger M; Tandon V; Thomas S; Friedman L; Cheng D; Johnstone D; Lowenstein E; Roberts R.; GOSSETTI, Bruno |
| Contributors: | Devereaux, Pj; Mrkobrada, M; Sessler, Di; Leslie, K; Alonso Coello, P; Kurz, A; Villar, Jc; Sigamani, A; Biccard, Bm; Meyhoff, C; Parlow, Jl; Guyatt, G; Robinson, A; Garg, Ax; Rodseth, Rn; Botto, F; Lurati Buse, G; Xavier, D; Chan, Mt; Tiboni, M; Cook, D; Kumar, Pa; Forget, P; Malaga, G; Fleischmann, E; Amir, M; Eikelboom, J; Mizera, R; Torres, D; Wang, Cy; Vanhelder, T; Paniagua, P; Berwanger, O; Srinathan, S; Graham, M; Pasin, L; Le Manach, Y; Gao, P; Pogue, J; Whitlock, R; Lamy, A; Kearon, C; Baigent, C; Chow, C; Pettit, S; Chrolavicius, S; Yusuf, S; DeBeer J, POISE 2 I. n. v. e. s. t. i. g. a. t. o. r. s.; Patel, A; Dechert, W; Jackson, P; Allard, R; Dumerton Shore, D; Mccourt, J; Jones, Pm; Lavi, R; Lavi, S; Moor, R; Dresser, Gk; Gros, Ml; Schumann, Vc; Baur, M; Macdonald, C; Wirzba, B; Regalado, O; Srinathan, Sk; Ong, Dd; Todd, A; Abbas, S; Beattie, W; Chan, Vw; Chin, Kj; Wijeysundera, Dn; Graham, Mm; Irwin, M; Jacka, M; El Beheiry, H; Mcmullen, Sm; Macdonald, P; Akhtar, Z; Ayad, S; Buttar, M; Deroee, A; Eshraghi, Y; Fergany, A; Finnigan, P; Fu, A; Grady, M; Helper, S; Hesler, B; Honar, H; Hutcherson, M; Krebs, V |
| Publisher Information: | Massachusetts Medical Society:860 Winter Street:Waltham, MA 02451:(800)843-6356, (781)893-3800, EMAIL: nejmcust@mms.org, INTERNET: http://www.massmed.org/, Fax: (781)647-5785, (781)893-7368 |
| Publication Year: | 2014 |
| Collection: | Sapienza Università di Roma: CINECA IRIS |
| Description: | BACKGROUND: There is substantial variability in the perioperative administration of aspirin in patients undergoing noncardiac surgery, both among patients who are already on an aspirin regimen and among those who are not. METHODS: Using a 2-by-2 factorial trial design, we randomly assigned 10,010 patients who were preparing to undergo noncardiac surgery and were at risk for vascular complications to receive aspirin or placebo and clonidine or placebo. The results of the aspirin trial are reported here. The patients were stratified according to whether they had not been taking aspirin before the study (initiation stratum, with 5628 patients) or they were already on an aspirin regimen (continuation stratum, with 4382 patients). Patients started taking aspirin (at a dose of 200 mg) or placebo just before surgery and continued it daily (at a dose of 100 mg) for 30 days in the initiation stratum and for 7 days in the continuation stratum, after which patients resumed their regular aspirin regimen. The primary outcome was a composite of death or nonfatal myocardial infarction at 30 days. RESULTS: The primary outcome occurred in 351 of 4998 patients (7.0%) in the aspirin group and in 355 of 5012 patients (7.1%) in the placebo group (hazard ratio in the aspirin group, 0.99; 95% confidence interval [CI], 0.86 to 1.15; P=0.92). Major bleeding was more common in the aspirin group than in the placebo group (230 patients [4.6%] vs. 188 patients [3.8%]; hazard ratio, 1.23; 95% CI, 1.01, to 1.49; P=0.04). The primary and secondary outcome results were similar in the two aspirin strata. CONCLUSIONS: Administration of aspirin before surgery and throughout the early postsurgical period had no significant effect on the rate of a composite of death or nonfatal myocardial infarction but increased the risk of major bleeding. (Funded by the Canadian Institutes of Health Research and others; POISE-2 ClinicalTrials.gov number, NCT01082874.). Comment in The yin and yang of perioperative medicine. [N Engl J Med. 2014 |
| Document Type: | article in journal/newspaper |
| File Description: | STAMPA |
| Language: | English, Middle (1100-1500) |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/24679062; info:eu-repo/semantics/altIdentifier/wos/WOS:000334601600006; volume:370 (16); issue:Apr 17; firstpage:1494; lastpage:1503; numberofpages:10; journal:NEW ENGLAND JOURNAL OF MEDICINE; http://hdl.handle.net/11573/558006 |
| DOI: | 10.1056/NEJMoa1401105 |
| Availability: | http://hdl.handle.net/11573/558006; https://doi.org/10.1056/NEJMoa1401105 |
| Accession Number: | edsbas.2BF0B716 |
| Database: | BASE |