A preliminary study: aspirin discontinuation before elective operations; when is the optimal timing?

Purpose: To evaluate the optimum timing of aspirin cessation before noncardiac surgeries. We have conducted a pilot study to minimize the aspirin cessation time before various surgeries.

Methods: Eighty patients who were taking regular aspirin for secondary prevention undergoing elective surgical operations were enrolled in the study. We separated the patients into two groups. The control group had 35 patients who stopped aspirin intake 10 days before surgery. The study group had 45 patients who stopped their aspirin intake and underwent surgery one day after arachidonic acid aggregation tests were within normal limits. Bleeding, blood loss, and transfusion requirements were assessed perioperatively.

Results: The mean time between aspirin cessation and aspirin nonresponsiveness were found to be 4.2 days with a median value of 4 days. In addition, the mean time between aspirin cessation and operation day were found to be 5.5 days with a median value of 5 days. No perioperative bleeding, thromboembolic or cardiovascular complications were encountered.

Conclusion: Reducing time of aspirin cessation from 7-10 days to 4-5 days is a possibility for patients using aspirin for secondary prevention without increased perioperative complications.