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Aspirin in patients undergoing noncardiac surgery

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dc.contributor.author Devereaux, P.J.
dc.contributor.author Mrkobrada, M.
dc.contributor.author Sessler, D.I.
dc.contributor.author Leslie, K.
dc.contributor.author Alonso-Coello, P.
dc.contributor.author Kurz, A.
dc.contributor.author Villar, J.C.
dc.contributor.author Sigamani, A.
dc.contributor.author Biccard, B.M.
dc.contributor.author Meyhoff, C.S.
dc.contributor.author Parlow, J.L.
dc.contributor.author Guyatt, G.
dc.contributor.author Robinson, A.
dc.contributor.author Garg, A.X.
dc.contributor.author Rodseth, R.N.
dc.contributor.author Botto, F.
dc.contributor.author Lurati Buse, G.
dc.contributor.author Xavier, D.
dc.contributor.author Chan, M.T.V.
dc.contributor.author Tiboni, M.
dc.contributor.author Cook, D.
dc.contributor.author Kumar, P.A.
dc.contributor.author Forget, P.
dc.contributor.author Malaga, G.
dc.contributor.author Fleischmann, E.
dc.contributor.author Amir, M.
dc.contributor.author Eikelboom, J.
dc.contributor.author Mizera, R.
dc.contributor.author Torres, D.
dc.contributor.author Wang, C.Y.
dc.contributor.author VanHelder, T.
dc.contributor.author Paniagua, P.
dc.contributor.author Berwanger, O.
dc.contributor.author Srinathan, S.
dc.contributor.author Graham, M.
dc.contributor.author Pasin, L.
dc.contributor.author Le Manach, Y.
dc.contributor.author Gao, P.
dc.contributor.author Pogue, J.
dc.contributor.author Whitlock, R.
dc.contributor.author Lamy, A.
dc.contributor.author Kearon, C.
dc.contributor.author Baigent, C.
dc.contributor.author Chow, C.
dc.contributor.author Pettit, S.
dc.contributor.author Chrolavicius, S.
dc.contributor.author Yusuf, S.
dc.date.accessioned 2020-06-10T18:12:14Z
dc.date.available 2020-06-10T18:12:14Z
dc.date.issued 2014
dc.identifier.uri https://hdl.handle.net/20.500.12866/8067
dc.description.abstract 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. en_US
dc.language.iso eng
dc.publisher Massachusetts Medical Society
dc.relation.ispartof urn:issn:1533-4406
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Aged en_US
dc.subject Middle Aged en_US
dc.subject Treatment Failure en_US
dc.subject human en_US
dc.subject aged en_US
dc.subject female en_US
dc.subject male en_US
dc.subject risk assessment en_US
dc.subject priority journal en_US
dc.subject follow up en_US
dc.subject controlled study en_US
dc.subject major clinical study en_US
dc.subject outcome assessment en_US
dc.subject article en_US
dc.subject death en_US
dc.subject drug effect en_US
dc.subject placebo en_US
dc.subject Kaplan-Meier Estimate en_US
dc.subject multicenter study en_US
dc.subject drug withdrawal en_US
dc.subject randomized controlled trial en_US
dc.subject hospitalization en_US
dc.subject patient care en_US
dc.subject heart infarction en_US
dc.subject Myocardial Infarction en_US
dc.subject Postoperative Complications en_US
dc.subject postoperative period en_US
dc.subject hazard ratio en_US
dc.subject acetylsalicylic acid en_US
dc.subject treatment duration en_US
dc.subject bleeding en_US
dc.subject length of stay en_US
dc.subject factorial design en_US
dc.subject low drug dose en_US
dc.subject Surgical Procedures, Operative en_US
dc.subject clonidine en_US
dc.subject noncardiac surgery en_US
dc.subject Perioperative Care en_US
dc.subject perioperative period en_US
dc.subject preoperative treatment en_US
dc.subject Aspirin en_US
dc.subject Platelet Aggregation Inhibitors en_US
dc.subject Postoperative Hemorrhage en_US
dc.title Aspirin in patients undergoing noncardiac surgery en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1056/NEJMoa1401105
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00

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