Reduced Effect of Aspirin and Clopidogrel Following Hybrid Coronary Revascularization

Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
Ivy Susanne ModrauAnne-Mette Hvas

Abstract

Reduced effect of antiplatelet therapy following coronary artery bypass grafting is associated with reduced graft patency. We sought to evaluate the impact of hybrid coronary revascularization on the effect of aspirin and clopidogrel and whether high baseline platelet aggregation, high postoperative levels of platelet turnover, and acute-phase response may contribute to the effect. We prospectively studied platelet aggregation (VerifyNow and Multiplate Analyzer), platelet turnover (immature platelets, mean platelet volume, and thrombopoietin), and acute-phase reactants (C-reactive protein, von Willebrand factor, and coagulation factor VIII) in 40 patients undergoing elective hybrid coronary revascularization (off-pump surgical revascularization through J-hemisternotomy followed by percutaneous coronary intervention [PCI]). Preoperative blood samples on- and off-aspirin were compared with blood samples obtained postoperatively, following PCI when dual antiplatelet therapy had been initiated and at 1-year follow-up. The antiplatelet effect of aspirin was significantly reduced in the early postoperative period as measured by VerifyNow Aspirin but not by Multiplate ASPI test. The antiplatelet effect of clopidogrel was significantly...Continue Reading

Associated Clinical Trials

References

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Citations

May 29, 2015·Thrombosis and Haemostasis·S D KristensenM Maeng
Nov 8, 2018·The Journal of Thoracic and Cardiovascular Surgery·Andreas Lund HattesenAnne-Mette Hvas

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Methods Mentioned

BETA
coronary artery bypass
immunoprecipitation

Clinical Trials Mentioned

NCT01496664

Software Mentioned

VerifyNow Aspirin and Multiplate Analyzer
VerifyNow
VerifyNow Aspirin
Stata
GraphPad Prism
Multiplate Analyzer
VerifyNow P2Y 12

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