Acetyl Salicylic Acid [BSA]

Introduction: Coronary artery disease (CAD) is a costly problem and its presentations and risk factors may differ by sex. Objective: This study aimed to evaluate the risk factors profile and angiographic pattern of the patients undergoing coronary angiography, according to their gender. Methods: This cross-sectional study was conducted on 741 patients who were referred for coronary angiography from March to August 2018 at Imam Ali cardiovascular center, western Iran. Using a checklist, we collected the demographic, clinical, biochemical, and lab parameters and angiographic findings in these patients. Also, differences between groups were compared using Chi-square and independent t-tests. Results: Women were different from men in terms of the prevalence of hypertension (71.7% vs. 45.3%), diabetes mellitus (34.9% vs. 17.8%), and hypercholesterolemia (26.4% vs. 17.1%). Whereas, men were more likely to be smoker (28.7% vs. 0%) and obese (42.09 +/- 16.68 vs. 29.12 +/- 4.72). Total Cholesterol and Triglycerides were higher in women compared to men, which were statistically significant. Glucose plasma was significantly higher in women compared to men (p=0.01). Both atherogenic (low-density lipoprotein (LDL)) and protective (high-density lipoprotein (HDL)) cholesterol were higher in women than men. Women were more likely to take antiplatelet (i.e. Aspirin) and antihypertensive therapies (i.e. beta-Blocker, angiotensin receptor blockers (ARBs), and angiotensin converting enzyme (ACE) inhibitors) than men. Also, it was shown that, Men were more likely to have two-vessel disease (p=0.041) and three-vessel disease (P=0.013) compared to women. Disease in the right coronary artery (RCA) (28.9% vs. 14.4%), circumflex (LCx) (26.0% vs. 15.3%), and left anterior descending (LAD) (37.8% vs. 26.4%) was more plausible to occur in men compared to women (p=0.05). Conclusion: Access and use of health care programs are needed to control CAD risk factors. The findings of the current study showed the significance of gender in the extent of coronary artery blockages.

Background: It has been generally recommended that platelet function may recover after the recommended 5-day discontinuation period prior to operation. The technique of thromboelastography has been demonstrated to monitor intraoperative platelet function in liver transplantation and coronary bypass surgery. However, there is a dearth of literature that addresses the utility of thromboelastography in aspirin-treated patients undergoing fusion. Objectives: To introduce a functional method of monitoring coagulation and validate the effectiveness of thromboelastography perioperatively in assessing aspirin-treated patients undergoing posterior lumbar fusion. Study Design: This research used a retrospective study design. Setting: Orthopedic Department of Changhai Hospital,Shanghai, China and Orthopedic and Anesthesia Department of Changzheng Hospital. Methods: Eighty patients were divided into aspirin-naive and aspirin-treated groups in this study. They had equally undergone lumbar fusion surgery for at least one or more segments between January and June 2018. They matched for age, gender, number of fused segments, and surgical procedures. The coagulation profile, including the reaction time (R), kinetics (K), maximal amplitude (MA), alpha-angle, and coagulation index (CI), platelet inhibition ratio (PIR) was analyzed by thromboelastogram (TEG) prior to operation and on preoperative days 1, 3, and 5. Correlation analysis included parameters such as waiting time, intraoperative blood loss, and postoperative drainage. Results: Perioperatively, the TEG values including R, K, MA, alpha-angle, and CI, PIR, and correlation analysis showed no significant difference between the 2 groups, respectively (P > 0.05). Limitations: First, the relatively small number of patients recruited limits control over other factors; larger studies may need to confirm our findings. Second, the patients were objectively less healthy with more medication treatment, which may result in a variance in the amount of blood loss. Randomized controlled studies are needed to further confirm these results. Conclusions: TEG may be a helpful method to monitor perioperative platelet function in aspirin-treated patients undergoing fusion. It may be comparatively safe to relax the restriction of the aspirin-discontinued therapeutic window to approximately 2 to 3 days prior to surgery.