Aspirin Use Prior to Coronary Artery Bypass Grafting Surgery: a Systematic Review

Curr Cardiol Rep. 2017 Feb;19(2):18. doi: 10.1007/s11886-017-0822-5.


Purpose of review: Aspirin use before coronary artery bypass graft (CABG) surgery has been a puzzling question for years. Controversy existed regarding the overall benefits vs. risk of pre-operative aspirin use and was translated to conflicting guidelines from major societies.

Recent findings: Observational studies have suggested a reduced mortality with pre-operative aspirin use. A meta-analysis of randomized controlled trials showed increased risk of post-operative bleeding with aspirin, with no associated increased mortality risk. A recent large randomized controlled trial did not find a significant difference in bleeding risk or post-operative mortality with pre-CABG aspirin use. The results of available studies showed a beneficial effect with pre-CABG aspirin use by decreasing thrombotic complications and perioperative myocardial infarction, with an associated adverse risk of bleeding that did not affect mortality rates. Given overall benefit-risk assessment, we are in favor of pre-operative aspirin use in CABG patients.

Keywords: Aspirin; Cardiac surgery; Coronary artery bypass graft; Pre-operative.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Aspirin / adverse effects
  • Aspirin / therapeutic use*
  • Coronary Artery Bypass*
  • Coronary Artery Disease / therapy*
  • Humans
  • Meta-Analysis as Topic
  • Myocardial Infarction / chemically induced
  • Platelet Aggregation Inhibitors / adverse effects
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Postoperative Hemorrhage / chemically induced
  • Practice Guidelines as Topic
  • Preoperative Care
  • Randomized Controlled Trials as Topic
  • Risk Assessment


  • Platelet Aggregation Inhibitors
  • Aspirin