Impact of Adding Aspirin to Beta-Blocker and Statin in High-Risk Patients Undergoing Major Vascular Surgery

In this study we evaluated the benefits of adding aspirin (A) to BB and S (ABBS), with/without angiotensin-converting enzyme inhibitor (ACE-I) on postoperative outcome in high-risk patients undergoing major vascular surgery.Methods: Analysis of consecutive patients undergoing elective vascular surgery at the University of Michigan Cardiovascular Center was performed. Univariate and multivariate analyses were done using cardiac risk index [Revised Cardiac Risk Index (RCRI), coronary artery disease (CAD), insulin-dependent diabetes mellitus (IDDM), cerebral vascular disease, renal dysfunction, congestive heart failure, and major surgery]; pulmonary disease; and A, BB, S (ABBS) ± ACE-I use. Baseline clinical characteristics and medication were adjusted using propensity scores. Endpoints were bleeding, 30-day MI, stroke, and 12-month mortality.Results: Between 2003 and 2010, 4,149 arterial procedures were performed, 819 of which were risk stratified as RCRI ≥3. The incidence of MI was 3-fold lower (2.5% vs. 7.8%, OR 0.31, 95% CI 0.15–0.61, P = 0.001) in ABBS ± ACE-I (n = 513) as compared with non-ABBS ± ACE-I (n = 306). The 12-month mortality was 8-fold lower in ABBS ± ACE-I as compared non-ABBS ± ACE-I (5.9% vs. 37.5%, HR 0.13, 95% CI 0.08–0.20, P 
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: Basic Data Underlying Clinical Decision-Making in Endovascular Therapy Source Type: research