Abstract
Early post-operative aspirin improves survival in patients undergoing coronary artery bypass graft (CABG). However, most patients do not benefit of aspirin after CABG, still remaining at risk of thrombotic events due to insufficient platelet inhibition, specifically via the thromboxane (TX) pathway. We evaluated the effect of two aspirin doses (100 or 325 mg daily, enteric coated formulations) on platelet function and TX biosynthesis in patients after CABG and assessed whether the incidence of residual platelet reactivity could be reduced by the higher dose. Fifty-six patients undergoing CABG were randomly assigned to 100 or 325 mg aspirin daily for five days in a prospective single-centre study. Treatment effect was assessed by measuring either platelet function (light-transmission aggregometry and point-of-care PFA-100® ) or TX biosynthesis in collagen-stimulated platelets, serum, urine, and in lipopolysaccharide (LPS)-cultured whole blood (WB). An insufficient TX inhibition was observed with 100 mg aspirin but not with the higher dose. The different effect of the two doses was, however, highlighted by either TX (platelet- or serum-derived) or by PFA-100® but not by the other assays. In conclusion, early after CABG, the incidence of residual platelet activity was lower in patients who received 325 mg aspirin. Moreover, evidence was provided that different methods yield different results in the detection of aspirin resistance, rendering them not interchangeable.
| Original language | English |
|---|---|
| Pages (from-to) | 516-524 |
| Number of pages | 9 |
| Journal | Thrombosis and Haemostasis |
| Volume | 103 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 2010 |
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Keywords
- Aspirin
- Coronary surgery
- Platelet aggregation
- Platelet pharmacology
- Thromboxane
ASJC Scopus subject areas
- Hematology
Cite this
Effect of two doses of aspirin on thromboxane biosynthesis and platelet function in patients undergoing coronary surgery. / Brambilla, Marta; Parolari, Alessandro; Camera, Marina; Colli, Susanna; Eligini, Sonia; Centenaro, Chiara; Anselmo, Achille; Alamanni, Francesco; Tremoli, Elena.
In: Thrombosis and Haemostasis, Vol. 103, No. 3, 03.2010, p. 516-524.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effect of two doses of aspirin on thromboxane biosynthesis and platelet function in patients undergoing coronary surgery
AU - Brambilla, Marta
AU - Parolari, Alessandro
AU - Camera, Marina
AU - Colli, Susanna
AU - Eligini, Sonia
AU - Centenaro, Chiara
AU - Anselmo, Achille
AU - Alamanni, Francesco
AU - Tremoli, Elena
PY - 2010/3
Y1 - 2010/3
N2 - Early post-operative aspirin improves survival in patients undergoing coronary artery bypass graft (CABG). However, most patients do not benefit of aspirin after CABG, still remaining at risk of thrombotic events due to insufficient platelet inhibition, specifically via the thromboxane (TX) pathway. We evaluated the effect of two aspirin doses (100 or 325 mg daily, enteric coated formulations) on platelet function and TX biosynthesis in patients after CABG and assessed whether the incidence of residual platelet reactivity could be reduced by the higher dose. Fifty-six patients undergoing CABG were randomly assigned to 100 or 325 mg aspirin daily for five days in a prospective single-centre study. Treatment effect was assessed by measuring either platelet function (light-transmission aggregometry and point-of-care PFA-100® ) or TX biosynthesis in collagen-stimulated platelets, serum, urine, and in lipopolysaccharide (LPS)-cultured whole blood (WB). An insufficient TX inhibition was observed with 100 mg aspirin but not with the higher dose. The different effect of the two doses was, however, highlighted by either TX (platelet- or serum-derived) or by PFA-100® but not by the other assays. In conclusion, early after CABG, the incidence of residual platelet activity was lower in patients who received 325 mg aspirin. Moreover, evidence was provided that different methods yield different results in the detection of aspirin resistance, rendering them not interchangeable.
AB - Early post-operative aspirin improves survival in patients undergoing coronary artery bypass graft (CABG). However, most patients do not benefit of aspirin after CABG, still remaining at risk of thrombotic events due to insufficient platelet inhibition, specifically via the thromboxane (TX) pathway. We evaluated the effect of two aspirin doses (100 or 325 mg daily, enteric coated formulations) on platelet function and TX biosynthesis in patients after CABG and assessed whether the incidence of residual platelet reactivity could be reduced by the higher dose. Fifty-six patients undergoing CABG were randomly assigned to 100 or 325 mg aspirin daily for five days in a prospective single-centre study. Treatment effect was assessed by measuring either platelet function (light-transmission aggregometry and point-of-care PFA-100® ) or TX biosynthesis in collagen-stimulated platelets, serum, urine, and in lipopolysaccharide (LPS)-cultured whole blood (WB). An insufficient TX inhibition was observed with 100 mg aspirin but not with the higher dose. The different effect of the two doses was, however, highlighted by either TX (platelet- or serum-derived) or by PFA-100® but not by the other assays. In conclusion, early after CABG, the incidence of residual platelet activity was lower in patients who received 325 mg aspirin. Moreover, evidence was provided that different methods yield different results in the detection of aspirin resistance, rendering them not interchangeable.
KW - Aspirin
KW - Coronary surgery
KW - Platelet aggregation
KW - Platelet pharmacology
KW - Thromboxane
UR - http://www.scopus.com/inward/record.url?scp=77749289650&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77749289650&partnerID=8YFLogxK
U2 - 10.1160/TH09-07-0470
DO - 10.1160/TH09-07-0470
M3 - Article
C2 - 20076848
AN - SCOPUS:77749289650
VL - 103
SP - 516
EP - 524
JO - Thrombosis and Haemostasis
JF - Thrombosis and Haemostasis
SN - 0340-6245
IS - 3
ER -