of Platelet Inhibitors with Emergency CABG
physicians would just keep doing what they did last year, the
problem would not get worse. But, no, that would be too simple.
We now have platelet inhibitors. What is the risk of platelet
inhibitors when mixed with CABG surgery? You have seen the case:
The PTCA failed, they were given a platelet inhibitor just prior
to the failed PTCA, they are bleeding from the hole in the coronary
where the PCI wire perforated. What happens next? Approximately
2% to 4% of patients undergo urgent or emergency coronary artery
bypass grafting (CABG) for complications of percutaneous coronary
intervention (PCI) after treatment with glycoprotein (GP) IIb/IIIa
inhibitors. Unfortunately the risk of Death 15%, MI 12%, and CVA
5% are increased by the lethal combination of platelet inhibitors
and emergency CABG. Eptifibatide
and tirofiban less risk than abciximab in the setting of emergency
or urgent CABG after failed PCI.
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