Acute clopidogrel use and outcomes for blood tranfusion in CABG pt

This is a good study
This study invilve 2,858 NSTE ACS patients undergoing CABG at 264 hospitals participating in the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC/AHA Guidelines) Initiative.
the patterns of acute clopidogrel therapy and its association with bleeding risks among those having "early" CABG less than or at 5 days the use of clopidogrel was associated with a significant increase in blood transfusions more than or =4 U of blood '27.7% vs. 18.4%, OR 1.70, 95% CI 1.32 to 2.19'. In contrast, acute clopidogrel therapy was not associated with higher bleeding risks if CABG was delayed >5 days 'adjusted OR 1.18, 95% CI 0.54 to 2.58'.
CONCLUSIONS: Despite guideline recommendations, the overwhelming majority of NSTE ACS patients treated with acute clopidogrel needing CABG have their surgery within 5 days failure to delay surgery is associated with increased blood transfusion requirements that must be weighed against the potential clinical and economic impacts of such delays.