Preoperative Aspirin Resistance does not Increase Myocardial Injury during Off-pump Coronary Artery Bypass Surgery.
10.3346/jkms.2011.26.8.1041
- Author:
Hyun Joo KIM
1
;
Jung Man LEE
;
Jeong Hwa SEO
;
Jun Hyeon KIM
;
Deok Man HONG
;
Jae Hyon BAHK
;
Ki Bong KIM
;
Yunseok JEON
Author Information
1. Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. jeonyunseok@gmail.com
- Publication Type:Original Article
- Keywords:
Aspirin;
Coronary Artery Bypass, Off-Pump;
Drug Resistance;
Hemorrhage;
Troponin I
- MeSH:
Aged;
Aspirin/*administration & dosage;
Cohort Studies;
Coronary Artery Bypass, Off-Pump/*adverse effects;
Coronary Disease/*surgery;
Drug Resistance;
Female;
Humans;
Male;
Middle Aged;
Myocardial Infarction/etiology;
Myocardial Reperfusion Injury/*prevention & control;
Platelet Aggregation Inhibitors/*administration & dosage;
Postoperative Hemorrhage/etiology;
Preoperative Care/methods;
Prospective Studies;
Stroke/etiology;
Troponin I/blood
- From:Journal of Korean Medical Science
2011;26(8):1041-1046
- CountryRepublic of Korea
- Language:English
-
Abstract:
We performed a prospective cohort trial on 220 patients undergoing elective off-pump coronary artery bypass surgery and taking aspirin to evaluate the effect of aspirin resistance on myocardial injury. The patients were divided into aspirin responders and aspirin non-responders by the value of the aspirin reaction units obtained preoperatively using the VerifyNow(TM) Aspirin Assay. The serum levels of troponin I were measured before surgery and 1, 6, 24, 48 and 72 hr after surgery. In-hospital major adverse cardiac and cerebrovascular events, graft occlusion, the postoperative blood loss and reexploration for bleeding were recorded. Of the 220 patients, 181 aspirin responders (82.3%) and 39 aspirin non-responders (17.7%) were defined. There were no significant differences in troponin I levels (ng/mL) between aspirin responders and aspirin non-responders: preoperative (0.04 +/- 0.08 vs 0.03 +/- 0.06; P = 0.56), postoperative 1 hr (0.72 +/- 0.87 vs 0.86 +/- 1.10; P = 0.54), 6 hr (2.92 +/- 8.76 vs 1.50 +/- 2.40; P = 0.94), 24 hr (4.16 +/- 13.44 vs 1.25 +/- 1.95; P = 0.52), 48 hr (2.15 +/- 7.06 vs 0.65 +/- 0.95; P = 0.64) and 72 hr (1.20 +/- 4.63 vs 0.38 +/- 0.56; P = 0.47). Moreover, no significant differences were observed with regard to in-hospital outcomes. In conclusion, preoperative aspirin resistance does not increase myocardial injury in patients undergoing off-pump coronary artery bypass surgery. Postoperative dual antiplatelet therapy might have protected aspirin resistant patients.
