ホンダ　ゴロウ   HONDA Gorou   本田　五郎    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Management of Patients Receiving Antiplatelet Therapy During Gastroenterological Surgery: A Multicenter Prospective Cohort Study (GSATT)
掲載誌名	正式名：Annals of surgery 略　 称：Ann Surg ISSNコード：15281140/00034932
掲載区分	国外
巻・号・頁	280(1),pp.82-90
著者・共著者	FUJIKAWA Takahisa, HASEGAWA Suguru, TAKAHASHI Ryo, NAITO Shigetoshi, KAIHARA Satoshi, URYUHARA Kenji, HIRATA Keiji, TAMURA Toshihisa, TERAJIMA Hiroaki, KAWAI Takayuki, OKABE Hiroshi, MACHIMOTO Takafumi, TANAKA Hirokazu, HONMA Shusaku, FURUMOTO Katsuyoshi, HONDA Goro, UEMURA Shuichiro, NISHITAI Ryuta, HIDA Koya, AOYAMA Ryuhei, WADA Seidai, HIROSE Tetsuro, OBAMA Kazutaka
発行年月	2024/07
概要	OBJECTIVE:This study aimed to evaluate the effect of continuing preoperative aspirin monotherapy on surgical outcomes in patients receiving antiplatelet therapy (APT).BACKGROUND:The effectiveness of continuing preoperative aspirin monotherapy in patients undergoing APT in preventing thromboembolic consequences is mostly unknown.METHODS:This prospective multicenter cohort study on the Safety and Feasibility of Gastroenterological Surgery in Patients Undergoing Antithrombotic Therapy (GSATT study) conducted at 14 clinical centers enrolled and screened patients between October 2019 and December 2021. The participants (n=1170) were assigned to the continued-APT group, discontinued-APT group, or non-APT group, and the surgical outcomes of each group were compared. Propensity score matching was performed between the continued and discontinued-APT groups to investigate the effect of continuing preoperative aspirin therapy on thromboembolic complications.RESULTS:The rate of thromboembolic complications in the continued-APT group was substantially lower than that in the non-APT or discontinued-APT groups (0.5% vs 2.6% vs. 2.9%; P =0.027). Multivariate investigation of the entire cohort revealed that discontinuation of APT ( P <0.001) and chronic anticoagulant use ( P <0.001) were independent risk factors for postoperative thromboembolism. The post-matching evaluation demonstrated that the rates of thromboembolic complications were significantly different between the continued and discontinued-APT groups (0.6% vs 3.3%; P =0.012).CONCLUSIONS:APT discontinuation after elective gastroenterological surgery increases the risk of thromboembolic consequences, whereas continuing preoperative aspirin greatly reduces this risk. The continuation of preoperative aspirin therapy in APT-received patients is considered one of the best alternatives for preventing thromboembolism during elective gastroenterological surgery.
DOI	10.1097/SLA.0000000000006136
PMID	37870247