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...
Main Authors: | , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2017-01-01
|
Series: | PLoS ONE |
Online Access: | http://europepmc.org/articles/PMC5513419?pdf=render |
_version_ | 1818948160180977664 |
---|---|
author | Jiwon Lee Chul-Woo Jung Yunseok Jeon Tae Kyong Kim Youn Joung Cho Chang-Hoon Koo Yoon Hyeong Choi Ki-Bong Kim Ho Young Hwang Hang-Rae Kim Ji-Young Park |
author_facet | Jiwon Lee Chul-Woo Jung Yunseok Jeon Tae Kyong Kim Youn Joung Cho Chang-Hoon Koo Yoon Hyeong Choi Ki-Bong Kim Ho Young Hwang Hang-Rae Kim Ji-Young Park |
author_sort | Jiwon Lee |
collection | DOAJ |
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. |
first_indexed | 2024-12-20T08:42:23Z |
format | Article |
id | doaj.art-9afa71113ac34a158bc1ae9e5c19f068 |
institution | Directory Open Access Journal |
issn | 1932-6203 |
language | English |
last_indexed | 2024-12-20T08:42:23Z |
publishDate | 2017-01-01 |
publisher | Public Library of Science (PLoS) |
record_format | Article |
series | PLoS ONE |
spelling | doaj.art-9afa71113ac34a158bc1ae9e5c19f0682022-12-21T19:46:21ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01127e018046610.1371/journal.pone.0180466Effects of preoperative aspirin on perioperative platelet activation and dysfunction in patients undergoing off-pump coronary artery bypass graft surgery: A prospective randomized study.Jiwon LeeChul-Woo JungYunseok JeonTae Kyong KimYoun Joung ChoChang-Hoon KooYoon Hyeong ChoiKi-Bong KimHo Young HwangHang-Rae KimJi-Young ParkThe 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.http://europepmc.org/articles/PMC5513419?pdf=render |
spellingShingle | Jiwon Lee Chul-Woo Jung Yunseok Jeon Tae Kyong Kim Youn Joung Cho Chang-Hoon Koo Yoon Hyeong Choi Ki-Bong Kim Ho Young Hwang Hang-Rae Kim Ji-Young Park Effects of preoperative aspirin on perioperative platelet activation and dysfunction in patients undergoing off-pump coronary artery bypass graft surgery: A prospective randomized study. PLoS ONE |
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 |
url | http://europepmc.org/articles/PMC5513419?pdf=render |
work_keys_str_mv | AT jiwonlee effectsofpreoperativeaspirinonperioperativeplateletactivationanddysfunctioninpatientsundergoingoffpumpcoronaryarterybypassgraftsurgeryaprospectiverandomizedstudy AT chulwoojung effectsofpreoperativeaspirinonperioperativeplateletactivationanddysfunctioninpatientsundergoingoffpumpcoronaryarterybypassgraftsurgeryaprospectiverandomizedstudy AT yunseokjeon effectsofpreoperativeaspirinonperioperativeplateletactivationanddysfunctioninpatientsundergoingoffpumpcoronaryarterybypassgraftsurgeryaprospectiverandomizedstudy AT taekyongkim effectsofpreoperativeaspirinonperioperativeplateletactivationanddysfunctioninpatientsundergoingoffpumpcoronaryarterybypassgraftsurgeryaprospectiverandomizedstudy AT younjoungcho effectsofpreoperativeaspirinonperioperativeplateletactivationanddysfunctioninpatientsundergoingoffpumpcoronaryarterybypassgraftsurgeryaprospectiverandomizedstudy AT changhoonkoo effectsofpreoperativeaspirinonperioperativeplateletactivationanddysfunctioninpatientsundergoingoffpumpcoronaryarterybypassgraftsurgeryaprospectiverandomizedstudy AT yoonhyeongchoi effectsofpreoperativeaspirinonperioperativeplateletactivationanddysfunctioninpatientsundergoingoffpumpcoronaryarterybypassgraftsurgeryaprospectiverandomizedstudy AT kibongkim effectsofpreoperativeaspirinonperioperativeplateletactivationanddysfunctioninpatientsundergoingoffpumpcoronaryarterybypassgraftsurgeryaprospectiverandomizedstudy AT hoyounghwang effectsofpreoperativeaspirinonperioperativeplateletactivationanddysfunctioninpatientsundergoingoffpumpcoronaryarterybypassgraftsurgeryaprospectiverandomizedstudy AT hangraekim effectsofpreoperativeaspirinonperioperativeplateletactivationanddysfunctioninpatientsundergoingoffpumpcoronaryarterybypassgraftsurgeryaprospectiverandomizedstudy AT jiyoungpark effectsofpreoperativeaspirinonperioperativeplateletactivationanddysfunctioninpatientsundergoingoffpumpcoronaryarterybypassgraftsurgeryaprospectiverandomizedstudy |