Preoperative platelet response to collagen is associated with myocardial injury after off-pump coronary bypass graft in patients taking aspirin

BACKGROUND: We hypothesized that, even in patients taking aspirin, the variance of preoperative platelet response to collagen might be associated with myocardial injury during coronary artery bypass graft (CABG) surgery. Therefore, we evaluated the relationship between preoperative whole-blood aggregometry (WBA) by collagen and the postoperative myocardial injuries. METHODS: For 44 patients who were scheduled for elective off-pump CABG and taking aspirin, WBA was measured by the impedance method in the presence of collagen (2 mg/ml or 5 mg/ml) as stimulatory agents. After CABG, myocardial injury was evaluated by analysis of the creatine kinase (CK), creatine kinase-MB (CK-MB), and lactate dehydrogenase (LD), and by electrocardiography. RESULTS: High response group (n = 13) on preoperative WBA with collagen (2 and 5 mg/ml) showed significantly higher postoperative cardiac enzyme levels (CK, CK-MB and LD) than those of low response group (n = 31). CONCLUSIONS: In patients who take aspirin and undergoing off-pump CABG, the preoperative platelet response to collagen is correlated with postoperative myocardial injury.