Abstract
On-pump cardiac surgery may trigger inflammation and accelerate platelet cyclooxygenase-1 renewal, thereby modifying low-dose aspirin pharmacodynamics. Thirty-seven patients on standard aspirin 100 mg once-daily were studied before surgery and randomized within 36 hours postsurgery to 100 mg once-daily, 100 mg twice-daily, or 200 mg once-daily for 90 days. On day 7 postsurgery, immature and mature platelets, platelet mass, thrombopoietin, glycocalicin, leukocytes, C-reactive protein, and interleukin-6 significantly increased. Interleukin-6 significantly correlated with immature platelets. At day 7, patients randomized to 100 mg once-daily showed a significant increase in serum thromboxane (TX)B2 within the 24-hour dosing interval and urinary TXA2 metabolite (TXM) excretion. Aspirin 100 mg twice-daily lowered serum TXB2 and prevented postsurgery TXM increase (P < 0.01), without affecting prostacyclin metabolite excretion. After cardiac surgery, shortening the dosing interval, but not doubling the once-daily dose, rescues the impaired antiplatelet effect of low-dose aspirin and prevents platelet activation associated with acute inflammation and enhanced platelet turnover.
| Original language | English |
|---|---|
| Pages (from-to) | 849-858 |
| Number of pages | 10 |
| Journal | Clinical Pharmacology and Therapeutics |
| Volume | 102 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Nov 1 2017 |
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ASJC Scopus subject areas
- Pharmacology
- Pharmacology (medical)
Cite this
On-pump Cardiac Surgery Enhances Platelet Renewal and Impairs Aspirin Pharmacodynamics : Effects of Improved Dosing Regimens. / Cavalca, V.; Rocca, B.; Veglia, F.; Petrucci, G.; Porro, B.; Myasoedova, V.; De Cristofaro, R.; Turnu, L.; Bonomi, A.; Songia, P.; Cavallotti, L.; Zanobini, M.; Camera, M.; Alamanni, F.; Parolari, A.; Patrono, C.; Tremoli, E.
In: Clinical Pharmacology and Therapeutics, Vol. 102, No. 5, 01.11.2017, p. 849-858.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - On-pump Cardiac Surgery Enhances Platelet Renewal and Impairs Aspirin Pharmacodynamics
T2 - Effects of Improved Dosing Regimens
AU - Cavalca, V.
AU - Rocca, B.
AU - Veglia, F.
AU - Petrucci, G.
AU - Porro, B.
AU - Myasoedova, V.
AU - De Cristofaro, R.
AU - Turnu, L.
AU - Bonomi, A.
AU - Songia, P.
AU - Cavallotti, L.
AU - Zanobini, M.
AU - Camera, M.
AU - Alamanni, F.
AU - Parolari, A.
AU - Patrono, C.
AU - Tremoli, E.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - On-pump cardiac surgery may trigger inflammation and accelerate platelet cyclooxygenase-1 renewal, thereby modifying low-dose aspirin pharmacodynamics. Thirty-seven patients on standard aspirin 100 mg once-daily were studied before surgery and randomized within 36 hours postsurgery to 100 mg once-daily, 100 mg twice-daily, or 200 mg once-daily for 90 days. On day 7 postsurgery, immature and mature platelets, platelet mass, thrombopoietin, glycocalicin, leukocytes, C-reactive protein, and interleukin-6 significantly increased. Interleukin-6 significantly correlated with immature platelets. At day 7, patients randomized to 100 mg once-daily showed a significant increase in serum thromboxane (TX)B2 within the 24-hour dosing interval and urinary TXA2 metabolite (TXM) excretion. Aspirin 100 mg twice-daily lowered serum TXB2 and prevented postsurgery TXM increase (P < 0.01), without affecting prostacyclin metabolite excretion. After cardiac surgery, shortening the dosing interval, but not doubling the once-daily dose, rescues the impaired antiplatelet effect of low-dose aspirin and prevents platelet activation associated with acute inflammation and enhanced platelet turnover.
AB - On-pump cardiac surgery may trigger inflammation and accelerate platelet cyclooxygenase-1 renewal, thereby modifying low-dose aspirin pharmacodynamics. Thirty-seven patients on standard aspirin 100 mg once-daily were studied before surgery and randomized within 36 hours postsurgery to 100 mg once-daily, 100 mg twice-daily, or 200 mg once-daily for 90 days. On day 7 postsurgery, immature and mature platelets, platelet mass, thrombopoietin, glycocalicin, leukocytes, C-reactive protein, and interleukin-6 significantly increased. Interleukin-6 significantly correlated with immature platelets. At day 7, patients randomized to 100 mg once-daily showed a significant increase in serum thromboxane (TX)B2 within the 24-hour dosing interval and urinary TXA2 metabolite (TXM) excretion. Aspirin 100 mg twice-daily lowered serum TXB2 and prevented postsurgery TXM increase (P < 0.01), without affecting prostacyclin metabolite excretion. After cardiac surgery, shortening the dosing interval, but not doubling the once-daily dose, rescues the impaired antiplatelet effect of low-dose aspirin and prevents platelet activation associated with acute inflammation and enhanced platelet turnover.
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UR - http://www.scopus.com/inward/citedby.url?scp=85026484520&partnerID=8YFLogxK
U2 - 10.1002/cpt.702
DO - 10.1002/cpt.702
M3 - Article
C2 - 28379623
AN - SCOPUS:85026484520
VL - 102
SP - 849
EP - 858
JO - Clinical Pharmacology and Therapeutics
JF - Clinical Pharmacology and Therapeutics
SN - 0009-9236
IS - 5
ER -