Cor Vasa 2010, 52(Suppl.):52-58 | DOI: 10.33678/cor.2010.206

Aspirin resistance after coronary artery bypass grafting

František Bednář1,*, Pavel Osmančík1, Tomáš Vaněk2, Petr Widimský1
1 III. interní-kardiologická klinika
2 Kardiochirurgická klinika, Kardiocentrum, Fakultní nemocnice Královské Vinohrady a 3. lékařská fakulta Univerzity Karlovy, Praha, Česká republika

Aspirin administration after surgical myocardial revascularization improves not only early patency, particularly that of the venous grafts but, also, and more importantly, it significantly improves clinical postoperative outcomes.
Several recent papers have consistently reported an inadequate inhibitory effect of aspirin on platelet function in the early postoperative period, giving rise to what is now referred to as acquired aspirin insufficiency (resistance). The paper is an extensive overview of current concepts regarding the issue including its pathogenesis, diagnosis, and clinical relevance. The paper includes a list of the authors' own publications addressing the topic.

Keywords: Aspirin resistance; Coronary artery bypass surgery; Platelets

Published: December 1, 2010  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Bednář F, Osmančík P, Vaněk T, Widimský P. Aspirin resistance after coronary artery bypass grafting. Cor Vasa. 2010;52(Suppl.):52-58. doi: 10.33678/cor.2010.206.
Download citation

References

  1. Motwani JG, Topol EJ. Aortocoronary saphenous vein graft disease: pathogenesis, predisposition, and prevention. Circulation 1998;97:916-931. Go to original source... Go to PubMed...
  2. Zimmermann N, Gams E, Hohlfeld T. Aspirin in coronary artery bypass surgery: new aspects of and alternatives for an old antithrombotic agent. Eur J Cardiothorac Surg 2008;34:93-108. Go to original source... Go to PubMed...
  3. Kasotakis G, Pipinos, II, Lynch TG. Current evidence and clinical implications of aspirin resistance. J Vasc Surg 2009;50:1500-1510. Go to original source... Go to PubMed...
  4. Benedek IH, Joshi AS, Pieniaszek HJ, et al. Variability in the pharmacokinetics and pharmacodynamics of low dose aspirin in healthy male volunteers. J Clin Pharmacol 1995;35:1181-1186. Go to original source... Go to PubMed...
  5. Mangano DT. Aspirin and mortality from coronary bypass surgery. N Engl J Med 2002;347:1309-1317. Go to original source... Go to PubMed...
  6. Collaborative overview of randomised trials of antiplatelet therapy-I: Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. Antiplatelet Trialists' Collaboration. BMJ 1994;308:81-106. Go to PubMed...
  7. Goldman S, Copeland J, Moritz T, et al. Improvement in early saphenous vein graft patency after coronary artery bypass surgery with antiplatelet therapy: results of a Veterans Administration Cooperative Study. Circulation 1988;77:1324-1332. Go to original source... Go to PubMed...
  8. Goldman S, Copeland J, Moritz T, et al. Saphenous vein graft patency 1 year after coronary artery bypass surgery and effects of antiplatelet therapy. Results of a Veterans Administration Cooperative Study. Circulation 1989;80:1190-1197. Go to original source... Go to PubMed...
  9. Goldman S, Copeland J, Moritz T, et al. Long-term graft patency (3 years) after coronary artery surgery. Effects of aspirin: results of a VA Cooperative study. Circulation 1994;89:1138-1143. Go to original source... Go to PubMed...
  10. Goldman S, Copeland J, Moritz T, et al. Starting aspirin therapy after operation. Effects on early graft patency. Department of Veterans Affairs Cooperative Study Group. Circulation 1991;84:520-526. Go to original source... Go to PubMed...
  11. Gavaghan TP, Gebski V, Baron DW. Immediate postoperative aspirin improves vein graft patency early and late after coronary artery bypass graft surgery. A placebo-controlled, randomized study. Circulation 1991;83:1526-1533. Go to original source... Go to PubMed...
  12. Eagle KA, Guyton RA, Davidoff R, et al. ACC/AHA 2004 guideline update for coronary artery bypass graft surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1999 Guidelines for Coronary Artery Bypass Graft Surgery). Circulation 2004;110:e340-e437. Go to original source...
  13. Stein PD, Schunemann HJ, Dalen JE, et al. Antithrombotic therapy in patients with saphenous vein and internal mammary artery bypass grafts: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004;126(3 Suppl):600S-608S. Go to original source... Go to PubMed...
  14. Patrono C, Coller B, Dalen JE, et al. Platelet-active drugs: the relationships among dose, effectiveness, and side effects. Chest 2001;119(1 Suppl): 39S-63S. Go to original source... Go to PubMed...
  15. Zimmermann N, Wenk A, Kim U, et al. Functional and biochemical evaluation of platelet aspirin resistance after coronary artery bypass surgery. Circulation 2003;108:542-547. Go to original source... Go to PubMed...
  16. Zimmermann N, Kurt M, Wenk A, et al. Is cardiopulmonary bypass a reason for aspirin resistance after coronary artery bypass grafting? Eur J Cardiothorac Surg 2005;27:606-610. Go to original source... Go to PubMed...
  17. Poston RS, Gu J, Brown JM, et al. Endothelial injury and acquired aspirin resistance as promoters of regional thrombin formation and early vein graft failure after coronary artery bypass grafting. J Thorac Cardiovasc Surg 2006;131:122-130. Go to original source... Go to PubMed...
  18. Bednar F, Osmancik P, Vanek T, et al. Platelet activity and aspirin efficacy after off-pump compared with on-pump coronary artery bypass surgery: results from the prospective randomized trial PRAGUE 11-Coronary Artery Bypass and REactivity of Thrombocytes (CABARET). J Thorac Cardiovasc Surg 2008;136:1054-1060. Go to original source... Go to PubMed...
  19. Bednar F, Osmancik P, Hlavicka J, et al. Aspirin is insufficient in inhibition of platelet aggregation and thromboxane formation early after coronary artery bypass surgery. J Thromb Thrombolysis 2009;27:394-399. Go to original source... Go to PubMed...
  20. Kempfert J, Anger K, Rastan A, et al. Postoperative development of aspirin resistance following coronary artery bypass. Eur J Clin Invest 2009;39: 769-774. Go to original source... Go to PubMed...
  21. Sanioglu S, Tetik S, Sokullu O, et al. Aspirin resistance after CABG. Thorac Cardiovasc Surg 2009;57:281-285. Go to original source... Go to PubMed...
  22. Michelson AD. Platelet function testing in cardiovascular diseases. Circulation 2004;110:e489-e493. Go to original source... Go to PubMed...
  23. Catella-Lawson F, Reilly MP, Kapoor SC, et al. Cyclooxygenase inhibitors and the antiplatelet effects of aspirin. N Engl J Med 2001;345:1809-1817. Go to original source... Go to PubMed...
  24. Weerasinghe A, Taylor KM. The platelet in cardiopulmonary bypass. Ann Thorac Surg 1998;66:2145-2152. Go to original source... Go to PubMed...
  25. Zimmermann N, Kurt M, Winter J, et al. Aspirin-induced platelet inhibition in patients undergoing cardiac surgery. Platelets 2007;18:528-534. Go to original source... Go to PubMed...
  26. Muriithi EW, Belcher PR, Day SP, et al. Heparin-induced platelet dysfunction and cardiopulmonary bypass. Ann Thorac Surg 2000;69:1827-1832. Go to original source... Go to PubMed...
  27. Krasopoulos G, Brister SJ, Beattie WS, et al. Aspirin "resistance" and risk of cardiovascular morbidity: systematic review and meta-analysis. BMJ 2008; 336:195-198. Go to original source... Go to PubMed...
  28. Yilmaz MB, Balbay Y, Caldir V, et al. Late saphenous vein graft occlusion in patients with coronary bypass: possible role of aspirin resistance. Thromb Res 2005;115:25-29. Go to original source... Go to PubMed...
  29. Bach J, Kammerer I, Isgro F, et al. The impact of intravenous aspirin administration on platelet aspirin resistance after on-pump coronary artery bypass surgery. Platelets 2009;20:150-157. Go to original source... Go to PubMed...
  30. Gurbuz AT, Zia AA, Vuran AC, et al. Postoperative clopidogrel improves mid-term outcome after off-pump coronary artery bypass graft surgery: a prospective study. Eur J Cardiothorac Surg 2006;29:190-195. Go to original source... Go to PubMed...
  31. Kulik A. Clopidogrel and Aspirin versus Aspirin Alone After Coronary Bypass Surgery: Results from The Clopidogrel After Surgery For Coronary Artery Disease (CASCADE) Randomized Controlled Trial. AHA 2009, Late-Breaking Clinical Trials, 50. Go to original source...
  32. Fitzgerald GA, Reilly IA, Pedersen AK. The biochemical pharmacology of thromboxane synthase inhibition in man. Circulation 1985;72:1194-1201. Go to original source... Go to PubMed...




Cor et Vasa

You are accessing a site intended for medical professionals, not the lay public. The site may also contain information that is intended only for persons authorized to prescribe and dispense medicinal products for human use.

I therefore confirm that I am a healthcare professional under Act 40/1995 Coll. as amended by later regulations and that I have read the definition of a healthcare professional.