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News & Analysis Myocardial Infarction Risks Remain for Patients Undergoing Noncardiac Elective Surgery Mike Mitka, MSJ ashington, DC—Recent efforts to In the aspirin study, 5628 patients were taking clonidine (47.6%) had clinically im- reduce the not uncommon risk randomly assigned to receive either aspirin portant hypotension compared with 1854 W of myocardial infarction in pa- (200mgjustbeforesurgeryfollowedby100 patients (37.1%) receiving placebo, suggest- tients undergoing noncardiac surgery have mg of aspirin daily for 30 days postsurgery) ing a 32% increased risk with clonidine. Car- turned up empty. or placebo. Another 4998 patients who diac arrest occurred in 16 patients (0.3%) in Researchers presenting findings at the were already taking aspirin were randomly the clonidine group compared with 5 pa- Scientific Sessions of the American College assigned to continue aspirin therapy or to tients (0.1%) in the placebo group (De- of Cardiology (ACC) in March from 2 stud- take a placebo instead. At 30 days, 351 of vereaux PJ et al. N Engl J Med. doi:10.1056 ies using aspirin or clonidine found no re- 4998 patients (7.0%) in the aspirin group /NEJMoa1401106 [published online March duction in the rate of composite death or and 2355 of 5012 patients (7.1%) in the pla-
JAMA – American Medical Association
Published: May 21, 2014
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