title: Preoperative aspirin resistance does not increase myocardial injury during off-pump coronary artery bypass surgery.
abstract: We performed a prospective cohort trial on 220 patients undergoing elective off-pump coronary artery bypass surgery and taking aspirin to evaluate the effect of aspirin resistance on myocardial injury. The patients were divided into aspirin responders and aspirin non-responders by the value of the aspirin reaction units obtained preoperatively using the VerifyNow™ Aspirin Assay. The serum levels of troponin I were measured before surgery and 1, 6, 24, 48 and 72 hr after surgery. In-hospital major adverse cardiac and cerebrovascular events, graft occlusion, the postoperative blood loss and reexploration for bleeding were recorded. Of the 220 patients, 181 aspirin responders (82.3%) and 39 aspirin non-responders (17.7%) were defined. There were no significant differences in troponin I levels (ng/mL) between aspirin responders and aspirin non-responders: preoperative (0.04 ± 0.08 vs 0.03 ± 0.06; P = 0.56), postoperative 1 hr (0.72 ± 0.87 vs 0.86 ± 1.10; P = 0.54), 6 hr (2.92 ± 8.76 vs 1.50 ± 2.40; P = 0.94), 24 hr (4.16 ± 13.44 vs 1.25 ± 1.95; P = 0.52), 48 hr (2.15 ± 7.06 vs 0.65 ± 0.95; P = 0.64) and 72 hr (1.20 ± 4.63 vs 0.38 ± 0.56; P = 0.47). Moreover, no significant differences were observed with regard to in-hospital outcomes. In conclusion, preoperative aspirin resistance does not increase myocardial injury in patients undergoing off-pump coronary artery bypass surgery. Postoperative dual antiplatelet therapy might have protected aspirin resistant patients.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Kim
authors.forename: Jung-Man
authors.initials: JM
authors.lastname: Lee
authors.forename: Jeong Hwa
authors.initials: JH
authors.lastname: Seo
authors.forename: Jun-Hyeon
authors.initials: JH
authors.lastname: Kim
authors.forename: Deok-Man
authors.initials: DM
authors.lastname: Hong
authors.forename: Jae-Hyon
authors.initials: JH
authors.lastname: Bahk
authors.forename: Ki-Bong
authors.initials: KB
authors.lastname: Kim
authors.forename: Yunseok
authors.initials: Y
authors.lastname: Jeon
mesh_terms: D000368:Aged; D001241:Aspirin / Q000008:administration & dosage*; D015331:Cohort Studies; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D003327:Coronary Disease / Q000601:surgery*; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D019106:Postoperative Hemorrhage / Q000209:etiology; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D020521:Stroke / Q000209:etiology; D019210:Troponin I / Q000097:blood
chemical_list: D010975:Platelet Aggregation Inhibitors; D019210:Troponin I; D001241:Aspirin