1 / 6

PJ Devereaux, Population Health Research Institute, Hamilton, Canada

POISE-2. P eri O perative IS chemic E valuation- 2 Trial. Aspirin in Patients Undergoing Noncardiac Surgery. PJ Devereaux, Population Health Research Institute, Hamilton, Canada on behalf of POISE-2 Investigators. Background. Worldwide 200 million adults have noncardiac surgery annually

katen
Download Presentation

PJ Devereaux, Population Health Research Institute, Hamilton, Canada

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. POISE-2 PeriOperative ISchemic Evaluation-2 Trial Aspirin in Patients Undergoing Noncardiac Surgery PJ Devereaux, Population Health Research Institute, Hamilton, Canada on behalf of POISE-2 Investigators

  2. Background Worldwide 200 million adults have noncardiac surgery annually 10 million suffer major vascular complication MI is most common Surgery – associated with platelet activation thrombosis may be mechanism of periop MI Substantial variability in periop usage of aspirin aspirin-naive pts and pts taking aspirin chronically

  3. Methods Design – blinded RCT, 135 centres in 23 countries Eligibility criteria –undergoing noncardiac surgery, ≥45 yrs, at risk of vascular complication Recruitment –10,010 pts, July 2010 to Dec 2013 2 aspirin strata - Starting Stratum (n=5628), Continuation Stratum (n=4382) Intervention - aspirin/placebo (200 mg) just before surgery; continued daily (100 mg) 30 days in Starting and 7 days in Continuation Stratum Primary outcome: composite of death and nonfatal MI at 30 days

  4. Results

  5. Results Primary and 2nd outcome results similar in both aspirin strata 65% of patients received prophylactic anticoag Multivariable regression – life-threatening or major bleed independent predictor of periop MI HR, 1.82; (95% CI, 1.40-2.36); P<0.001 Post-hoc analyses suggest 1.0-1.3% absolute increase in life-threatening or major bleeding if aspirin started within 2 days after Sx risk decreases to 0.3% if started on day 8 after surgery

  6. Conclusions Perioperative aspirin did not prevent death or MI but increased risk of major bleeding Primary and 2nd outcome results consistent both aspirin strata Life-threatening and major bleeding independent predictor of MI Optimal time to restart aspirin 8 – 10 days after surgery

More Related