People who are taking aspirin regularly to thin their blood and are about to undergo coronary artery bypass surgery are usually told to stop the aspirin a week before the operation - but they could be better off if they keep taking it.

Taking aspirin up to the day coronary artery bypass grafting (CABG) is performed seems to speed lung function recovery afterwards, without increasing the risk of bleeding significantly, according to a report from Israel.

Release of a substance called thromboxane is associated with lung injury after heart bypass grafting, Dr. Rabin Gerrah at Assuta Medical Center in Tel Aviv and colleagues explain in their article in the medical journal Chest.

Aspirin is believed to inhibit release of thromboxane, so Gerrah’s group theorized that aspirin administration up until the day of surgery could improve outcomes.

They therefore followed 14 patients who took 100 milligrams of aspirin daily until the day of surgery and 18 whose aspirin therapy was stopped at least 7 days before surgery.

Those who continued with their aspirin had significantly lower thromboxane in fluid around the heart, better oxygen levels in their blood, and spent less time on a ventilator than the group who discontinued taking aspirin, the investigators report.

On the other hand, the need for blood transfusions was no different between the groups, indicating that bleeding complications were no worse with aspirin.

The researchers had excluded patients who had suffered a Heart attack and those with heart failure, but because patients like these have a higher level of thromboxane, “they will probably benefit even more from its inhibition.”

Based on their findings, Gerrah’s team recommends that aspirin therapy not be discontinued before coronary artery bypass surgery.

SOURCE: Chest, May 2005.