title: Aprotinin preserves hemostasis in aspirin-treated patients undergoing cardiopulmonary bypass.
abstract: Various clinical trials have shown that hemostasis is improved by the administration of aprotinin during cardiopulmonary bypass. However, this effect has not been proved for those patients treated preoperatively with aspirin. Therefore, a double-blind, placebo-controlled study was conducted to test the efficacy of low-dose aprotinin (2 x 10(6) KIU in the pump prime solution) in preserving hemostasis in 40 aspirin-treated (325 mg) patients undergoing coronary artery bypass grafting. Aprotinin brought about a decrease in the postoperative blood loss (p < 0.05). The in vitro bleeding test (Thrombostat) demonstrated that aprotinin preserved the platelet hemostatic function in aspirin-treated patients during cardiopulmonary bypass (p < 0.05). The inhibitory effects of aspirin on collagen-induced platelet aggregation and thromboxane production were not influenced by aprotinin treatment. The findings from the present study indicate that aprotinin preserves hemostasis in aspirin-treated patients during cardiopulmonary bypass, but aspirin's effect on platelets is maintained. Therefore, aprotinin seems to be a useful adjunct treatment in aspirin-treated patients undergoing coronary artery bypass grafting.
authors.affiliation: Thorax Center, University Hospital Groningen, The Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: Tabuchi
authors.forename: R C
authors.initials: RC
authors.lastname: Huet
authors.forename: A
authors.initials: A
authors.lastname: Sturk
authors.forename: L
authors.initials: L
authors.lastname: Eijsman
authors.forename: C R
authors.initials: CR
authors.lastname: Wildevuur
mesh_terms: D007611:Aprotinin / Q000494:pharmacology* / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use*; D001792:Blood Platelets / Q000187:drug effects* / Q000502:physiology; D002315:Cardiopulmonary Bypass; D004311:Double-Blind Method; D006487:Hemostasis / Q000187:drug effects*; D006488:Hemostasis, Surgical; D006801:Humans; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects; D013929:Thromboxane B2 / Q000097:blood
chemical_list: D013929:Thromboxane B2; D007611:Aprotinin; D001241:Aspirin