Possibility of application of low-frequency piezothromboelastografy method for the evaluation of haemostatic potential of blood in coronary bypass surgery on the background of long aspirinotherapy

Abstract

Aim. To assess the hemostatic system on the aspirin therapy background using the VerifyNow Aspirin test, as well as examining platelet aggregation and low-frequency piezothromboelastography in patients with coronary artery disease during coronary artery bypass grafting. Materials and methods. 100 people with coronary artery disease who were taking aspirin (75–100 mg daily) for more than 1 year were examined. The study was performed in the perioperative period of coronary bypass surgery without aspirin withdrawal. Evaluation of hemostasis was performed by the VerifyNow Aspirin тest (USA), platelet aggregation (Нelena Laboratories AggRAMTM, Britain) and the low-frequency piezothromboelastography (ARP-01M “Mednord”, Russia). Results. Patients included in the study were sensitive to aspirin when under long-term administration of a drug: indicator test was VerifyNow ARU 496,9 ± 21,3)%, the platelet aggregation to ADP and adrenaline was reduced by 46% and 52%, respectively. In the early postoperative period platelet aggregation of ADP decreased by 73,2%, collagen – 75,9%, and adrenaline – 82,64% in comparison with the control group. Perioperative hemorrhagic complications in the study group were not observed. Reduction of platelet aggregation after aspirin therapy was accompanied by an increase in thrombin activity of the blood, which allows for evaluation of the method of low-frequency piezothromboelastography (LPTEG). In the early postoperative period, the results of LPTEG, thrombin potential, and anticoagulant and fibrinolytic activity of blood were partially normalized without reaching the level of the control group. Conclusion. For the evaluation of hemostasis under aspirin therapy it is advisable to apply the low-frequency piezothromboelastography, which in contrast to the VerifyNow test and traditional platelet aggregation, allows one to reveal a degree of impairment in thrombin blood activity and to conduct an integrative assessment on all aspects of hemostasis.