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Quantitative and functional changes in platelets and their preservation during extracorporeal circulation
Insights
This study compared Ticlopidine and Dipyridamole effects on platelet function after open cardiac surgery. Both drugs demonstrated prophylactic benefits by reducing platelet reduction during extracorporeal circulation.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Pharmacology
Background:
- Open cardiac surgery and extracorporeal circulation significantly impact platelet count and function.
- Postoperative changes include reduced platelet count, altered fibrinogen levels, and increased Fibrin Degradation Products (FDP).
Purpose of the Study:
- To compare the platelet inhibitory effects of Ticlopidine and Dipyridamole in patients undergoing open cardiac surgery.
- To evaluate the drugs' prophylactic effects on platelet reduction during extracorporeal circulation.
Main Methods:
- Fifty patients undergoing open cardiac surgery were studied.
- Ticlopidine (250 mg/day) and Dipyridamole (1-2 mg/day) were administered pre-extracorporeal circulation.
- Platelet count, ADP-induced aggregation, platelet adhesiveness, fibrinogen, FDP, and prothrombin time were measured.
Main Results:
- Platelet count decreased significantly during bypass, with hyperthrombocythemia observed post-discharge.
- Ticlopidine markedly inhibited ADP-induced platelet aggregation, while Dipyridamole reduced platelet adhesiveness.
- Abnormally high FDP levels were noted in nearly half the patients, especially after valvular replacement.
Conclusions:
- Both Ticlopidine and Dipyridamole exhibit prophylactic effects in mitigating platelet reduction during cardiac surgery.
- The drugs differentially impact platelet aggregation and adhesiveness, suggesting distinct mechanisms of action.
Abstract:
Platelet count, ADP-aggregation and adhesiveness of platelets, fibrinogen, FDP, and prothrombin time were examined in 50 patients who had undergone open cardiac surgery. Ticlopidine (250 mg/day) and Dipyridamole (1-2 mg/day) were administered prior to the extracorporeal circulation and the platelet inhibitory effects were compared. Platelet count was reduced markedly with the initiation of bypass and the low level was maintained until the 3rd postoperative day. Hyperthrombocythemia was found after a week. ADP induced platelet aggregation and platelet adhesiveness were markedly depressed by the ACC. Fibrinogen showed low level during the ECC but the hyper-fibrinogenemic state was observed in postoperative course. FDP showed an abnormally high value in nearly half the cases, particularly in the cases of valvular replacement. Ticlopidine markedly depressed the ADP-aggregation and Dipyridamole reduced platelet adhesiveness and thus both drugs showed a prophylactic effect in the reduction of platelets.