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Original Article

Year: 2017 I  Volume: 6I  Issue: 3I  Pages: 1043–1047

Discontinuation practices of anti-platelet drugs in the peri-operative period and their outcomes on patient care

Renuka P Munshi, DNB Clinical Pharmacology; Sarayu A Pai, M.Pharm

Dept. of Clinical Pharmacology, T N Medical College and BYL Nair Charitable Hospital, Dr A.L. Nair Road, Mumbai Central (E), Mumbai-400 008



Background : The current study aimed to determine the discontinuation pattern of anti-platelet drugs in the peri-operative period and study the outcomes.

Methods : A retrospective cohort analysis of data of patients receiving anti-platelet drugs, who had also undergone cardiac interventions over one year from January 2014 to December 2014, was analysed. Informed consent waiver was obtained from the Institutional Ethics Committee. Six hundred and fifty case files of patients with coronary artery disease (CAD), who had undergone elective or emergent cardiac surgeries and were receiving anti-platelet drugs in the peri-operative period, were reviewed.

Results : Two hundred and ninety-one patients were diagnosed with CAD, six had history of cerebrovascular event/s and eight had congestive cardiac failure. One hundred and forty two patients underwent coronary artery bypass surgery while 508 underwent a cardiac procedure. None of the anti-platelet drugs were withdrawn in the peri-operative period as per patient records. Two hundred and two patients did not have any bleeding in the post-operative period, two patients had diffuse bleeding following the procedure, and 446 patients had localized surgical site bleeding. Two patients experienced acute coronary syndrome, whereas 18 had peripheral arterial thrombosis.

Conclusions : The study results showed that documentation practices in our hospital should be urgently improved. Although patients were verbally informed regarding the need to discontinue oral anti-platelet agents, documentation of the same was missing in the case files. Absence of major adverse events in the peri-operative period was the only indicator that discontinuation instructions were given and complied with by the patients.

Anti-platelet drugs
Discontinuation practices
Cardiac interventions
Peri-operative [eriod
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