Aspirin and noncardiovascular surgery – from Uptodate
Many patients who are scheduled to undergo surgery are taking aspirin for the primary or secondary prevention of cardiovascular disease. The best evidence regarding the impact of aspirin on outcomes comes from the POISE-2 trial in which 10,010 patients scheduled for noncardiac surgery, with or at risk of atherosclerotic disease, were randomly assigned to either aspirin or placebo . The primary outcome of death or nonfatal myocardial infarction (MI) at 30 days was similar in both groups as well as between those who were taking long-term aspirin and those who were not. As expected, major bleeding was more common in the aspirin group. Based on POISE-2, we recommend discontinuing aspirin about seven days before noncardiovascular surgery. While some patients in POISE-2 underwent vascular surgery, we are awaiting further data before revising recommendations about aspirin use in such patients.