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Effects of preoperative aspirin on perioperative platelet activation and dysfunction in patients undergoing off-pump coronary artery bypass graft surgery: A prospective randomized study

The benefit of aspirin use after coronary artery bypass graft surgery has been well proven. However, the effect of preoperative aspirin use in patients undergoing off-pump coronary artery bypass graft surgery (OPCAB) has not been evaluated sufficiently. To evaluate platelet function changes during O...

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Autores principales: Lee, Jiwon, Jung, Chul-Woo, Jeon, Yunseok, Kim, Tae Kyong, Cho, Youn Joung, Koo, Chang-Hoon, Choi, Yoon Hyeong, Kim, Ki-Bong, Hwang, Ho Young, Kim, Hang-Rae, Park, Ji-Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513419/
https://www.ncbi.nlm.nih.gov/pubmed/28715503
http://dx.doi.org/10.1371/journal.pone.0180466
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author Lee, Jiwon
Jung, Chul-Woo
Jeon, Yunseok
Kim, Tae Kyong
Cho, Youn Joung
Koo, Chang-Hoon
Choi, Yoon Hyeong
Kim, Ki-Bong
Hwang, Ho Young
Kim, Hang-Rae
Park, Ji-Young
author_facet Lee, Jiwon
Jung, Chul-Woo
Jeon, Yunseok
Kim, Tae Kyong
Cho, Youn Joung
Koo, Chang-Hoon
Choi, Yoon Hyeong
Kim, Ki-Bong
Hwang, Ho Young
Kim, Hang-Rae
Park, Ji-Young
author_sort Lee, Jiwon
collection PubMed
description The benefit of aspirin use after coronary artery bypass graft surgery has been well proven. However, the effect of preoperative aspirin use in patients undergoing off-pump coronary artery bypass graft surgery (OPCAB) has not been evaluated sufficiently. To evaluate platelet function changes during OPCAB due to preoperative aspirin use, we conducted a randomized controlled trial using flow cytometry and the Multiplate(®) analyzer. Forty-eight patients scheduled for elective OPCAB were randomized to the aspirin continuation (100 mg/day until operative day) and discontinuation (4 days before the operative day) groups. Platelet function was measured using the platelet activation markers CD62P, CD63, and PAC-1 by flow cytometry, and platelet aggregation was measured using the Multiplate(®) analyzer, after the induction of anesthesia (baseline), at the end of the operation, and 24 and 48 h postoperatively. Findings of conventional coagulation assays, thromboelastography by ROTEM(®) assays, and postoperative bleeding—related clinical outcomes were compared between groups. No significant change in CD62P, CD63, or PAC-1 was observed at the end of the operation or 24 or 48 h postoperatively compared with baseline in either group. The area under the curve for arachidonic acid—stimulated platelet aggregation, measured by the Multiplate(®) analyzer, was significantly smaller in the aspirin continuation group (P < 0.01). However, chest tube drainage and intraoperative and postoperative transfusion requirements did not differ between groups. Our study showed that preoperative use of aspirin for OPCAB did not affect perioperative platelet activation, but it impaired platelet aggregation, which did not affect postoperative bleeding, by arachidonic acid.
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spelling pubmed-55134192017-08-07 Effects of preoperative aspirin on perioperative platelet activation and dysfunction in patients undergoing off-pump coronary artery bypass graft surgery: A prospective randomized study Lee, Jiwon Jung, Chul-Woo Jeon, Yunseok Kim, Tae Kyong Cho, Youn Joung Koo, Chang-Hoon Choi, Yoon Hyeong Kim, Ki-Bong Hwang, Ho Young Kim, Hang-Rae Park, Ji-Young PLoS One Research Article The benefit of aspirin use after coronary artery bypass graft surgery has been well proven. However, the effect of preoperative aspirin use in patients undergoing off-pump coronary artery bypass graft surgery (OPCAB) has not been evaluated sufficiently. To evaluate platelet function changes during OPCAB due to preoperative aspirin use, we conducted a randomized controlled trial using flow cytometry and the Multiplate(®) analyzer. Forty-eight patients scheduled for elective OPCAB were randomized to the aspirin continuation (100 mg/day until operative day) and discontinuation (4 days before the operative day) groups. Platelet function was measured using the platelet activation markers CD62P, CD63, and PAC-1 by flow cytometry, and platelet aggregation was measured using the Multiplate(®) analyzer, after the induction of anesthesia (baseline), at the end of the operation, and 24 and 48 h postoperatively. Findings of conventional coagulation assays, thromboelastography by ROTEM(®) assays, and postoperative bleeding—related clinical outcomes were compared between groups. No significant change in CD62P, CD63, or PAC-1 was observed at the end of the operation or 24 or 48 h postoperatively compared with baseline in either group. The area under the curve for arachidonic acid—stimulated platelet aggregation, measured by the Multiplate(®) analyzer, was significantly smaller in the aspirin continuation group (P < 0.01). However, chest tube drainage and intraoperative and postoperative transfusion requirements did not differ between groups. Our study showed that preoperative use of aspirin for OPCAB did not affect perioperative platelet activation, but it impaired platelet aggregation, which did not affect postoperative bleeding, by arachidonic acid. Public Library of Science 2017-07-17 /pmc/articles/PMC5513419/ /pubmed/28715503 http://dx.doi.org/10.1371/journal.pone.0180466 Text en © 2017 Lee et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Lee, Jiwon
Jung, Chul-Woo
Jeon, Yunseok
Kim, Tae Kyong
Cho, Youn Joung
Koo, Chang-Hoon
Choi, Yoon Hyeong
Kim, Ki-Bong
Hwang, Ho Young
Kim, Hang-Rae
Park, Ji-Young
Effects of preoperative aspirin on perioperative platelet activation and dysfunction in patients undergoing off-pump coronary artery bypass graft surgery: A prospective randomized study
title Effects of preoperative aspirin on perioperative platelet activation and dysfunction in patients undergoing off-pump coronary artery bypass graft surgery: A prospective randomized study
title_full Effects of preoperative aspirin on perioperative platelet activation and dysfunction in patients undergoing off-pump coronary artery bypass graft surgery: A prospective randomized study
title_fullStr Effects of preoperative aspirin on perioperative platelet activation and dysfunction in patients undergoing off-pump coronary artery bypass graft surgery: A prospective randomized study
title_full_unstemmed Effects of preoperative aspirin on perioperative platelet activation and dysfunction in patients undergoing off-pump coronary artery bypass graft surgery: A prospective randomized study
title_short Effects of preoperative aspirin on perioperative platelet activation and dysfunction in patients undergoing off-pump coronary artery bypass graft surgery: A prospective randomized study
title_sort effects of preoperative aspirin on perioperative platelet activation and dysfunction in patients undergoing off-pump coronary artery bypass graft surgery: a prospective randomized study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513419/
https://www.ncbi.nlm.nih.gov/pubmed/28715503
http://dx.doi.org/10.1371/journal.pone.0180466
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