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Effect of two doses of aspirin on thromboxane biosynthesis and platelet function in patients undergoing coronary

Marta Brambilla1, Alessandro Parolari, Marina Camera

  • 1Centro Cardiologico Monzino, IRCCS, Via Parea, 4, 20138 Milano, Italy.

Thrombosis and Haemostasis
|January 16, 2010
PubMed

Insights

Higher aspirin doses (325 mg) reduce residual platelet activity after coronary artery bypass graft (CABG) surgery compared to lower doses (100 mg). This improved platelet inhibition is crucial for preventing thrombotic events in post-CABG patients.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Hematology

Background:

  • Aspirin post-coronary artery bypass graft (CABG) surgery improves survival.
  • Many patients remain at risk for thrombotic events due to insufficient platelet inhibition via the thromboxane (TX) pathway.

Purpose of the Study:

  • To evaluate the effect of two aspirin doses (100 mg vs. 325 mg) on platelet function and TX biosynthesis in post-CABG patients.
  • To determine if a higher aspirin dose reduces residual platelet reactivity.

Main Methods:

  • Prospective single-center study of 56 CABG patients randomly assigned to 100 mg or 325 mg enteric-coated aspirin daily for five days.
  • Assessed platelet function using light-transmission aggregometry and PFA-100(R).
  • Measured TX biosynthesis in stimulated platelets, serum, urine, and lipopolysaccharide-cultured whole blood.

Main Results:

  • Insufficient TX inhibition was observed with 100 mg aspirin but not with 325 mg.
  • The higher aspirin dose (325 mg) resulted in lower incidence of residual platelet activity.
  • Different assays yielded varying results for aspirin resistance, indicating they are not interchangeable.

Conclusions:

  • Early post-CABG, 325 mg aspirin reduces residual platelet activity more effectively than 100 mg.
  • Assay methodology impacts the detection of aspirin resistance in post-CABG patients.

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