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Eagle, K.A., Brundage, B.H., Chaitman, B.R., Ewy, G.A., Fleisher, L.A., Hertzer, N.R., et al. (1996) ACC/AHA Task Force Special Report. Guidelines for Perioperative Cardiovascular Evaluation for Noncardiac Surgery. Circulation, 93, 1278-1317.

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• TITLE: Does Clopidogrel Reduce Major Adverse Cardiac Events in Patients Undergoing Non-Cardiac Vascular Surgery?

  AUTHORS: Syed U. Ahmed, Michael Fisher, Mohammed S. Ahmed, Mark W. Noble

  KEYWORDS: Clopidogrel, Major Adverse Cardiac Events, Post-Op Complications, Vascular Surgery

  JOURNAL NAME: Open Access Library Journal, Vol.11 No.10, October 16, 2024

  ABSTRACT: Aims: To determine the influence of Clopidogrel on major adverse cardiac events (MACE’s) in patients undergoing non-cardiac vascular surgery. Introduction: Antiplatelet agents are regularly withdrawn prior to surgery due to concerns over bleeding risk, however there is some compelling retrospective data to suggest that while patients on antiplatelet agents do have higher rates of bleeding their overall prognosis is better off. Methods: We performed a prospective observational study on non-cardiac vascular surgery patients who had a successful non-cardiac related operation at the Royal Liverpool University Hospital. Baseline clinical parameters were systematically collected and in-hospital MACE’s were recorded on post-op days 1 - 4. An average Eagle risk score was calculated for each group and statistical analysis using a statistical package for social sciences was used to determine significance. Results: 101 total patients were identified and 75 patients were deemed eligible for inclusion. 27 (36%) had peripheral arterial bypass surgery, 24 (32%) had an endovascular repair, 13 (17%) had carotid endarterectomy and 11 (15%) had open aneurysm repair. 14 (19%) of the recruited participants were taking clopidogrel prior to surgery. The mean Eagle risk score was 1.22 ± 0.93 in the non-clopidogrel arm and 0.92 ± 0.75 in the clopidogrel group. There was no significant difference in Eagle risk scores between the two groups. 13 (21%) of 61 patients not taking clopidogrel experienced MACE vs. 0 in those taking clopidogrel (P = 0.03). Conclusion: Our study suggests that clopidogrel reduces major adverse cardiac events in patients undergoing non-cardiac vascular surgery even in higher risk patients.