title: Aprotinin has no effect on platelet activation and adhesion during cardiopulmonary bypass.
abstract: Aprotinin reduces blood loss following cardiopulmonary bypass operations (CPB) by the prevention of hyperfibrinolysis. Its influence on circulating platelets is uncertain. In this prospective trial we investigated activation, adhesion, and aggregation receptors on the platelet surface in 20 patients who underwent elective coronary artery bypass grafting. These patients were randomly assigned to receive either a high dose of aprotinin or placebo. Flow cytometry was performed to determine platelet activation [P-selectin, glycoprotein (GP) 53], adhesive (GP Ib), and aggregatory (GP IIb-IIIa) receptors on circulating platelets, before, during, and after CPB. Aprotinin had neither a significant effect on platelet activation nor on adhesive and aggregatory receptors. Plasma levels of D-dimers were measured before and after CPB to assess fibrinolytic activity. D-dimers following CPB and chest tube drainage were significantly less in the aprotinin group. We conclude that aprotinin reduces blood loss by its effect on fibrinolysis but has no direct influence on platelet function.
authors.affiliation: Department of Cardiac, Thoracic, and Vascular Surgery, University of Regensburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Wahba
authors.forename: G
authors.initials: G
authors.lastname: Black
authors.forename: M
authors.initials: M
authors.lastname: Koksch
authors.forename: G
authors.initials: G
authors.lastname: Rothe
authors.forename: J
authors.initials: J
authors.lastname: Preuner
authors.forename: G
authors.initials: G
authors.lastname: Schmitz
authors.forename: D E
authors.initials: DE
authors.lastname: Birnbaum
mesh_terms: D000328:Adult; D007611:Aprotinin / Q000009:adverse effects*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002315:Cardiopulmonary Bypass; D005260:Female; D005434:Flow Cytometry; D006490:Hemostatics / Q000009:adverse effects*; D006801:Humans; D008297:Male; D015539:Platelet Activation / Q000187:drug effects*
chemical_list: D006490:Hemostatics; D007611:Aprotinin