On-pump Cardiac Surgery Enhances Platelet Renewal and Impairs Aspirin Pharmacodynamics: Effects of Improved Dosing Regimens

Bianca Rocca, Giovanna Petrucci, Raimondo De Cristofaro, Carlo Patrono, V. Cavalca, F. Veglia, B. Porro, V. Myasoedova, L. Turnu, A. Bonomi, P. Songia, L. Cavallotti, M. Zanobini, M. Camera, F. Alamanni, A. Parolari, E. Tremoli

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

17 Citazioni (Scopus)

Abstract

On-pump cardiac surgery may trigger inflammation and accelerate platelet cyclooxygenase-1 renewal, thereby modifying low-dose aspirin pharmacodynamics. Thirty-seven patients on standard aspirin 100 mg once-daily were studied before surgery and randomized within 36 hours postsurgery to 100 mg once-daily, 100 mg twice-daily, or 200 mg once-daily for 90 days. On day 7 postsurgery, immature and mature platelets, platelet mass, thrombopoietin, glycocalicin, leukocytes, C-reactive protein, and interleukin-6 significantly increased. Interleukin-6 significantly correlated with immature platelets. At day 7, patients randomized to 100 mg once-daily showed a significant increase in serum thromboxane (TX)B2within the 24-hour dosing interval and urinary TXA2metabolite (TXM) excretion. Aspirin 100 mg twice-daily lowered serum TXB2and prevented postsurgery TXM increase (P < 0.01), without affecting prostacyclin metabolite excretion. After cardiac surgery, shortening the dosing interval, but not doubling the once-daily dose, rescues the impaired antiplatelet effect of low-dose aspirin and prevents platelet activation associated with acute inflammation and enhanced platelet turnover.
Lingua originaleEnglish
pagine (da-a)849-858
Numero di pagine10
RivistaCLINICAL PHARMACOLOGY &amp; THERAPEUTICS
Volume102
DOI
Stato di pubblicazionePubblicato - 2017

Keywords

  • Aged
  • Aged, 80 and over
  • Aspirin
  • Blood Platelets
  • Coronary Artery Bypass
  • Coronary Artery Disease
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pharmacology
  • Pharmacology (medical)
  • Platelet Aggregation Inhibitors
  • Treatment Outcome

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