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Aspirin-induced platelet inhibition in patients undergoing cardiac surgery

Norbert Zimmermann1, Muhammed Kurt, Joachim Winter

  • 1Federal Institute for Drugs and Medical Devices, Bonn, Germany. nzimmermann@bfarm.de

Platelets
|October 25, 2007
PubMed

Insights

Platelet function is altered after cardiac surgery, potentially impairing aspirin

Area of Science:

  • Cardiovascular Surgery
  • Hematology
  • Pharmacology

Background:

  • Cardiac surgery, including coronary artery bypass grafting (CABG) and aortic valve replacement (AVR), can alter platelet function.
  • Platelet aggregation may increase post-surgery, and response to aspirin can be insufficient, particularly after CABG.

Purpose of the Study:

  • To investigate the antiplatelet effect of aspirin in patients undergoing CABG and AVR.
  • To determine if platelet activation after cardiac surgery impairs aspirin's efficacy.

Main Methods:

  • Compared aspirin's antiplatelet effect in 20 CABG patients and 20 AVR patients.
  • Measured arachidonic acid-induced platelet aggregation and thromboxane formation pre- and post-surgery (days 1, 5, 10).
  • Assessed in vitro aspirin inhibition of platelet function.

Main Results:

  • Thromboxane formation increased significantly after AVR but not after CABG, despite aspirin treatment in CABG patients.
  • In vitro aspirin inhibition of platelet function was attenuated post-surgery in both CABG and AVR groups.
  • Platelet aggregation and thromboxane formation were higher pre-surgery in patients with aortic stenosis.

Conclusions:

  • Thromboxane formation increases post-AVR, suggesting impaired platelet function.
  • Aspirin's antiplatelet effect may be reduced after CABG due to increased platelet activity.
  • Both CABG and AVR are associated with a post-operative in vitro "resistance" to aspirin's effects on platelets.

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