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Factors Associated with Inadequate Management of Antiplatelet Agents in Perioperative Period of Non-Cardiac Surgeries

BACKGROUND: The current guidelines dispose recommendations to manage antiplatelet agents in the perioperative period; however, the daily medical practices lack standardization. OBJECTIVES: To asses factors associated with inadequate management of antiplatelet agents in the perioperative period of no...

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Autores principales: Borges, Juliana Maria Dantas Mendonça, Almeida, Pamella de Assis, do Nascimento, Mariana Martins Gonzaga, Barreto Filho, José Augusto Soares, Rosa, Mario Borges, Sousa, Antonio Carlos Sobral
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Cardiologia - SBC 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6199502/
https://www.ncbi.nlm.nih.gov/pubmed/30281684
http://dx.doi.org/10.5935/abc.20180162
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author Borges, Juliana Maria Dantas Mendonça
Almeida, Pamella de Assis
do Nascimento, Mariana Martins Gonzaga
Barreto Filho, José Augusto Soares
Rosa, Mario Borges
Sousa, Antonio Carlos Sobral
author_facet Borges, Juliana Maria Dantas Mendonça
Almeida, Pamella de Assis
do Nascimento, Mariana Martins Gonzaga
Barreto Filho, José Augusto Soares
Rosa, Mario Borges
Sousa, Antonio Carlos Sobral
author_sort Borges, Juliana Maria Dantas Mendonça
collection PubMed
description BACKGROUND: The current guidelines dispose recommendations to manage antiplatelet agents in the perioperative period; however, the daily medical practices lack standardization. OBJECTIVES: To asses factors associated with inadequate management of antiplatelet agents in the perioperative period of non-cardiac surgeries. METHODS: Cross-sectional Study conducted in hospital from October 2014 to October 2016. The study dependent variable was a therapy that did not comply with the recommendations in the Brazilian Association of Cardiology (SBC) guidelines. The independent variables included some characteristics, the people in charge of the management and causes of lack of adherence to those guidelines. Variables were included in the multivariate model. Analysis was based on the odds ratio (OR) value and its respective 95% confidence interval (CI) estimated by means of logistic regression with 5% significance level. RESULTS: The sample was composed of adult patients submitted to non-cardiac surgeries and who would use acetylsalicylic acid (aspirin) or clopidogrel (n = 161). The management failed to comply with the recommendations in the guidelines in 80.75% of the sample. Surgeons had the highest number of noncomplying orientations (n = 63). After multivariate analysis it was observed that patients with a higher level of schooling (OR = 0.24; CI95% 0.07-0.78) and those with a previous episode of acute myocardial infarction (AMI) (OR = 0.18; CI95% 0.04-0.95) had a higher probability of using a therapy complying with the guidelines. CONCLUSION: Positive association between patients’ schooling level, or those with a history of previous AMI, with management of the use of aspirin and clopidogrel in the perioperative period of non-cardiac surgeries. However, diverging conducts stress the need of having internal protocol defined.
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spelling pubmed-61995022018-10-29 Factors Associated with Inadequate Management of Antiplatelet Agents in Perioperative Period of Non-Cardiac Surgeries Borges, Juliana Maria Dantas Mendonça Almeida, Pamella de Assis do Nascimento, Mariana Martins Gonzaga Barreto Filho, José Augusto Soares Rosa, Mario Borges Sousa, Antonio Carlos Sobral Arq Bras Cardiol Original Article BACKGROUND: The current guidelines dispose recommendations to manage antiplatelet agents in the perioperative period; however, the daily medical practices lack standardization. OBJECTIVES: To asses factors associated with inadequate management of antiplatelet agents in the perioperative period of non-cardiac surgeries. METHODS: Cross-sectional Study conducted in hospital from October 2014 to October 2016. The study dependent variable was a therapy that did not comply with the recommendations in the Brazilian Association of Cardiology (SBC) guidelines. The independent variables included some characteristics, the people in charge of the management and causes of lack of adherence to those guidelines. Variables were included in the multivariate model. Analysis was based on the odds ratio (OR) value and its respective 95% confidence interval (CI) estimated by means of logistic regression with 5% significance level. RESULTS: The sample was composed of adult patients submitted to non-cardiac surgeries and who would use acetylsalicylic acid (aspirin) or clopidogrel (n = 161). The management failed to comply with the recommendations in the guidelines in 80.75% of the sample. Surgeons had the highest number of noncomplying orientations (n = 63). After multivariate analysis it was observed that patients with a higher level of schooling (OR = 0.24; CI95% 0.07-0.78) and those with a previous episode of acute myocardial infarction (AMI) (OR = 0.18; CI95% 0.04-0.95) had a higher probability of using a therapy complying with the guidelines. CONCLUSION: Positive association between patients’ schooling level, or those with a history of previous AMI, with management of the use of aspirin and clopidogrel in the perioperative period of non-cardiac surgeries. However, diverging conducts stress the need of having internal protocol defined. Sociedade Brasileira de Cardiologia - SBC 2018-10 /pmc/articles/PMC6199502/ /pubmed/30281684 http://dx.doi.org/10.5935/abc.20180162 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Borges, Juliana Maria Dantas Mendonça
Almeida, Pamella de Assis
do Nascimento, Mariana Martins Gonzaga
Barreto Filho, José Augusto Soares
Rosa, Mario Borges
Sousa, Antonio Carlos Sobral
Factors Associated with Inadequate Management of Antiplatelet Agents in Perioperative Period of Non-Cardiac Surgeries
title Factors Associated with Inadequate Management of Antiplatelet Agents in Perioperative Period of Non-Cardiac Surgeries
title_full Factors Associated with Inadequate Management of Antiplatelet Agents in Perioperative Period of Non-Cardiac Surgeries
title_fullStr Factors Associated with Inadequate Management of Antiplatelet Agents in Perioperative Period of Non-Cardiac Surgeries
title_full_unstemmed Factors Associated with Inadequate Management of Antiplatelet Agents in Perioperative Period of Non-Cardiac Surgeries
title_short Factors Associated with Inadequate Management of Antiplatelet Agents in Perioperative Period of Non-Cardiac Surgeries
title_sort factors associated with inadequate management of antiplatelet agents in perioperative period of non-cardiac surgeries
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6199502/
https://www.ncbi.nlm.nih.gov/pubmed/30281684
http://dx.doi.org/10.5935/abc.20180162
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