To continue or discontinue aspirin in the perioperative period: a randomized, controlled clinical trial

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220 high-risk patients undergoing elective, high- or intermediate-risk non-cardiac surgery were randomized to receive either aspirin (75 mg) or placebo daily, beginning 7 days prior to surgery until the third postoperative day. The purpose of this study was to determine whether continuing aspirin therapy in the perioperative period significantly reduced myocardial damage and the incidence of major cardiac adverse events (MACEs), without affecting bleeding outcomes, over 30 days post-operation. Results indicated that, although the incidence of myocardial damage was similar between groups, aspirin significantly reduced the incidence of MACEs (relative risk reduction: 80%; absolute risk reduction: 7.2%) and cardio-cerebrovascular events. There were no significant differences in the perioperative bleeding outcomes between the two interventions.