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Aspirin response variability after major orthopedic surgery.
Chunjian Li1, Jack Hirsh, Debi Sloane
1Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China. lijay@njmu.edu.cn
Thrombosis Research
|May 12, 2012
Summary
Half of patients undergoing major orthopedic surgery showed a low response to aspirin, a common antiplatelet medication. This variability may be linked to increased platelet turnover after surgery.
Area of Science:
- Orthopedic Surgery
- Pharmacology
- Hematology
Background:
- Variability in aspirin's antiplatelet effect is known in cardiac surgery but poorly understood in orthopedic settings.
- The underlying mechanisms of aspirin response variability remain unclear in non-cardiac surgical patients.
Purpose of the Study:
- To investigate aspirin response variability in patients undergoing major orthopedic surgery.
- To explore potential mechanisms contributing to this variability.
Main Methods:
- A prospective cohort study of 12 patients undergoing hip or knee replacement, continuing daily aspirin.
- Platelet function (PLAA) and serum thromboxane B2 (TXB2) were measured perioperatively.
- Aspirin low response was defined as PLAA > 20%.
Main Results:
- Six patients (50%) exhibited aspirin low response, typically starting on post-operative days 3-4.
- Low responders had higher serum TXB2 levels compared to normal responders.
- Patients with low response showed a greater initial drop and faster recovery of platelet count.
Conclusions:
- Aspirin response variability is prevalent in major orthopedic surgery patients.
- Increased platelet turnover is a potential contributing factor to post-operative aspirin low response.
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