The authors show, in a large retrospective study, that the shorter the interval between cessation of clopidogrel and cardiac surgery, the more likely the patient is to present hemorrhagic complications and require an increased number of blood products. It is recommended that surgery be delayed at least 24 hours. Despite the limitations of a retrospective study, such a recommendation appears reasonable (i.e. clinically relevant) and is more compatible with usual practice where emergency surgery is often required.
– Jean-Franois Hardy