Download Aspirin before surgery – risks revealed

Tuesday April 1, 2014
Aspirin before surgery – risks revealed
Patients will be advised to stop taking regular aspirin and clonidine before noncardiac surgery after breakthrough research has revealed their harmful side-effects.
Melbourne anaesthetist and researcher Professor Kate Leslie led the Australian arm
of the international study, POISE 2, and said the results would dramatically change
advice to patients.
“Worldwide, 200 million adults undergo major non-cardiac surgery every year and
10 million of these patients will suffer a heart attack during or after the operation,”
Professor Leslie said.
“Yet doctors do not yet have a safe and effective method of preventing these serious
events.”
Professor Kate Leslie said the study, published in the New England Journal of
Medicine, evaluated the effectiveness of aspirin and clonidine in reducing the risk of
death or a heart attack after non-cardiac surgery. These studies involved over 10,000
patients at 135 institutions in 23 countries, including more than 15 hospitals in
Australia.
Aspirin is a commonly-used drug that is known to prevent heart attacks and
unwanted blood clotting in patients who are not having surgery. Clonidine is a drug
that is used to treat high blood pressure and pain. Approximately 20 per cent of all
adults undergoing non-cardiac surgery receive aspirin around the time of surgery,
but there is uncertainty about benefits for the heart in this setting. Similarly, some
doctors use clonidine to try to prevent heart attacks during surgery without being
certain of its effects.
The studies concluded that neither drug was effective in preventing heart attacks
after surgery and that there were side effects associated with the both of the drugs aspirin increased the risk of major bleeding and clonidine increased the risk of heart
attack and a drop in blood pressure.
“These results can benefit patients immediately because doctors can now ask their
patients to stop their aspirin prior to surgery, unless the blood clotting or stroke risk
is really high, and this will decrease their risk of a major bleeding event,” Professor
Leslie said.
“Likewise doctors can stop using courses of clonidine to prevent heart attacks in the
surgical setting, although some patients may still require it to treat severe pain.”
The research was endorsed the Australian and New Zealand College of Anaesthetists
(ANZCA) Trials Group.
For more information or to request interviews, please contact ANZCA Media Manager
Ebru Yaman on +61 3 8517 5303, +61 408 259 369 or [email protected]. Follow us
on Twitter @ANZCA.