Aspirin Resistance in Off-pump Coronary Artery Bypass Grafting

Overview

Journal Eur J Cardiothorac Surg

Publisher Oxford University Press

Specialties Cardiology & Vascular Diseases
General Surgery
Pulmonary Medicine

Date 2011 Jun 4

PMID 21636287

Citations 5

Authors

Zanxin Wang

Fei Gao

Jianlong Men

Jing Ren

Paul Modi

Minxin Wei

Affiliations

Soon will be listed here.

Abstract

Objective: Anti-platelet therapy with aspirin is the cornerstone of treatment after coronary artery bypass grafting (CABG). Aspirin resistance describes the clinical observation of the inability of aspirin to prevent thrombotic complications or the laboratory phenomenon of absence of the effect of aspirin on platelet inhibition tests. Off-pump CABG (OPCAB) is associated with reduced platelet activation and turnover compared to on-pump surgery which may indicate that aspirin is more effective after OPCAB. Our aim was to evaluate the efficacy of aspirin and incidence of aspirin resistance in patients undergoing OPCAB.

Methods: A total of 331 patients was recruited, of which 111 underwent primary OPCAB (group A) and 220 controls with ischaemic heart disease received medical therapy. Arachidonic acid-induced platelet aggregation and urinary 11-dehydro thromboxane B2 (11-dehydroTxB2) were measured at baseline and following aspirin administration on days 1, 4 and 10. A 6-month follow-up was completed in patients who developed aspirin resistance.

Results: On the first postoperative day, 78 patients (70.3%) were aspirin sensitive (AS) and 33 (29.7%) were aspirin resistant (AR). Of the latter, 18 (16.2%) and five (4.5%) patients remained resistant on days 4 and 10, respectively. AR patients had significantly greater platelet aggregation and urinary 11-dehydroTxB2 levels at all time points than those in the AS group. All patients in the AR group were AS by 6 months. All controls were sensitive to aspirin with similar platelet aggregation and 11-dehydroTxB2 to those in the AS group.

Conclusions: Aspirin resistance is a transient phenomenon during the early postoperative period in approximately 30% of patients undergoing OPCAB.

Citing Articles

Antiplatelet Resistance in Coronary Artery Bypass Grafting: A Systematic Review.

Thet M, Khosravi A, Egbulonu S, Oo A Surg Res Pract. 2024; 2024:1807241.

PMID: 38910604 PMC: 11193597. DOI: 10.1155/2024/1807241.

Prevalence rate of laboratory defined aspirin resistance in cardiovascular disease patients: A systematic review and meta-analysis.

Ebrahimi P, Farhadi Z, Behzadifar M, Shabaninejad H, Abolghasem Gorji H, Taheri Mirghaed M Caspian J Intern Med. 2020; 11(2):124-134.

PMID: 32509239 PMC: 7265510. DOI: 10.22088/cjim.11.2.124.

Impact of diabetes mellitus on coagulation function before and after off-pump coronary artery bypass grafting.

Wang D, Liu Y, Chen Z, Yang F, Zhang Z, Wei Y J Thorac Dis. 2020; 11(12):5517-5526.

PMID: 32030271 PMC: 6988029. DOI: 10.21037/jtd.2019.11.27.

Aspirin dosing frequency in the primary and secondary prevention of cardiovascular events.

Kim J, Becker R J Thromb Thrombolysis. 2016; 41(3):493-504.

PMID: 26739313 DOI: 10.1007/s11239-015-1307-2.

Aspirin resistance: current status and role of tailored therapy.

Grinstein J, Cannon C Clin Cardiol. 2012; 35(11):673-81.

PMID: 22740110 PMC: 6652698. DOI: 10.1002/clc.22031.

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