ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
Frequency of development of aspirin resistance in the early postoperative period and inadequate inhibition of thromboxane A2 production after coronary artery bypass surgery
Hayrettin Özkan1, İlker Kiriş2, Şenol Gülmen3, Hüseyin Okutan4, Filiz Alkaya Solmaz5, Kenan Abdurrahman Kara6
1Department of Cardiovascular Surgery, Kepez State Hospital, Antalya, Turkey
2Department of Cardiovascular Surgery, Private Medifema Hospital, İzmir, Turkey
3Department of Cardiovascular Surgery, Medicine Faculty of Süleyman Demirel University, Isparta, Turkey
4Department of Cardiovascular Surgery, Private Medical Park Hospital, Antalya, Turkey
5Department of Anesthesiology and Reanimation, Medicine Faculty of Süleyman Demirel University, Isparta, Turkey
6Department of Cardiovascular Surgery, Private Hisar Hospital, İstanbul, Turkey
DOI : 10.5606/tgkdc.dergisi.2018.15489
Background: This study aims to investigate the frequency of the development of aspirin resistance, whether or not this resistance was reversible, and to evaluate the efficiency of the mechanism of incomplete inhibition of thromboxane A2 in development of aspirin resistance in the early postoperative period in patients who had undergone coronary artery bypass grafting.

Methods: Eighty patients (55 males, 25 females; mean age 63.1±9.2 years; range 51 to 75 years) who underwent coronary artery bypass grafting between February 2009 and March 2010 at our clinic were prospectively evaluated. Venous blood samples were collected from all patients and evaluated by a platelet function analyzer in the preoperative period and on postoperative days 7 and 15. Aspirin resistance diagnosis was defined as collagen-epinephrine closure time less than 186 seconds. The urine levels of 11-dehidro thromboxane B2 were also measured on postoperative day one.

Results: Aspirin resistance was found in 23 patients (28.75%) in the preoperative period, in 31 patients (38.75%) on the postoperative seventh day and in 25 patients (31.25%) on the postoperative 15th day. The urine levels of 11-dehidro thromboxane B2 in patients with aspirin resistance on the postoperative seventh day were significantly higher than those in patients without aspirin resistance (p<0.001). The mean aortic cross-clamping time (p=0.003) and cardiopulmonary bypass time (p=0.029) in the patients with aspirin resistance on the postoperative seventh day were significantly higher than those in patients without aspirin resistance.

Conclusion: The results of this study suggest that aspirin resistance develops within the first seven days after coronary artery bypass grafting and is highly reversible, and that the mechanism of inadequate inhibition of thromboxane A2 by aspirin has a role in the development of aspirin resistance in the early postoperative period.

Keywords : Aspirin resistance; coronary artery bypass graft; platelet function analyzer-100; thromboxane A2
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