Abstract
Results Group of patients exposed to ASA preoperatively had lower values of ASPI test (P<0.001) comparing to patients not receiving ASA. However, we registered 28.6% ASA resistant patients. Both ASPI (P<0.001) and ADP (P<0.001) test values increased significantly at POD 4, suggesting postoperative platelet hyperactivity. Postoperatively, we registered 33.3% ASA resistant patients despite higher ASA dosing regimen. Conclusion MEA can recognize patients with ASA resistance during the both the pre- and post- CABG period. Postoperatively, ASA 300mg did not sufficiently inhibit platelet aggregation in 33.3% patients. In this subgroup, dual antiplatelet therapy with ASA and clopidogrel could be useful for maintaining graft patency, and preventing adverse ischemic events.
Highlights
Antiplatelet therapy (APT) is known to substantially reduce mortality and rate of ischaemic complications after coronary artery bypass grafting (CABG)
The purpose of the study was perioperative assessment of platelet function with respect to administered APT and cardiopulmonary bypass (CPB), and determination of patients with APT resistance who could benefit from more aggresive treatment strategy
Patients were divided into 4 groups with respect to their preoperative APT management
Summary
Antiplatelet therapy (APT) is known to substantially reduce mortality and rate of ischaemic complications after coronary artery bypass grafting (CABG). Rate of perioperative APT resistance varies widely and could be influenced by cardiopulmonary bypass (CPB). The purpose of the study was perioperative assessment of platelet function with respect to administered APT and CPB, and determination of patients with APT resistance who could benefit from more aggresive treatment strategy
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