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DOI: 10.1055/s-2007-967448
ASS non-responder rate using multiple aggregation tests has high prevalence in CABG patients
Objective: The predominant mechanism of early graft failure after coronary artery bypass grafting is associated with benefit of antiplatelet treatment of drugs like Acetyl-salicylic acid (ASA). The mechanisms for ASA resistance are multifactorial and can be screened by laboratory tests.
Methods: We determined platelet function using whole blood impedance aggregometry (IA) induced by ADP, arachidon acid (AA) and collagen (Coll), plateled aggregation (PA), Platelet Function Analyzer-100 (PFA-100). ASA 300mg was administered intravenously by 40 patients on 7.–9. post day after CABG. Non compliance administration was eliminated. Blood was drawn immediately before, 60 minutes and 24 hours after ASA application. ASA Non-Responsiveness (NR) was defined as maximal AA-induced PA below 20mm, corresponding to at least 66% inhibition.
Results: ASA NR was observed in 9 patients (22%) 1hr and 12 patients (30%) 24 hrs after ASA application. Before ASA injection, patients had significant greater IA values than 60 healthy controls (p<0.001) still PA determination was not different to control values. Most ADP and Coll-induced IA and PA values were not reduced 1 hour and 24 hours after ASA injection.
Conclusion: One third of the patients after CABG are non responders to ASA therapy. Screening for ASA resistance and optimised antiplatelet therapy may help to further improve patency of bypass grafts.