title: Polymorphisms and high on-aspirin platelet reactivity after off-pump coronary artery bypass grafting.
abstract: OBJECTIVE
  High on-aspirin residual platelet reactivity (RPR) after coronary artery bypass grafting (CABG) is a transient phenomenon with important implications for graft patency. This study was designed to determine the role of polymorphisms [TBXA2R (T924C), GPIIIa (Pl(A1/A2)), P2Y1 (A1622G), and GP1Bα (C1018T)] on RPR in Chinese patients undergoing off-pump CABG (OPCAB).
  
  
  METHODS
  Of 420 patients recruited to this study, 210 patients underwent primary OPCAB and 210 controls with ischemic heart disease received optimal medical therapy. Arachidonic acid-induced platelet aggregation and urinary 11-dehydro thromboxane B2 were measured at baseline and following aspirin administration on days 1, 4, 10, and on 6th month. Four polymorphisms were identified [TBXA2R (T924C), P2Y1 (A1622G), Pl(A1/A2) and GP1Bα (C1018T)].
  
  
  RESULTS
  On the first post-operative day, 62 patients (29.5%) were with high RPR and 148 (70.5%) were with low RPR. Of the former, 33 (15.7%), 10 (4.6%), and 0 (0%) patients remained with high RPR on days 4, 10, and on 6 month, respectively. No individuals with high RPR was found in controls. Logistic regression identified TBXA2R-924TT (OR = 4.5; 95% CI, 1.8-11.1) and body mass index > 27 kg/m(2) (OR = 2.73; 95% CI, 1.1-7.0) as independent risk factors for high on-aspirin RPR.
  
  
  CONCLUSIONS
  High on-aspirin RPR after OPCAB is associated with genetic polymorphism TBXA2R-924TT and obesity.
authors.affiliation: Department of Cardiovascular Surgery, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Zanxin
authors.initials: Z
authors.lastname: Wang
authors.forename: Fei
authors.initials: F
authors.lastname: Gao
authors.forename: Jianlong
authors.initials: J
authors.lastname: Men
authors.forename: Jie
authors.initials: J
authors.lastname: Yang
authors.forename: Paul
authors.initials: P
authors.lastname: Modi
authors.forename: Minxin
authors.initials: M
authors.lastname: Wei
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D044466:Asian People / Q000235:genetics; D001241:Aspirin / Q000627:therapeutic use*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002681:China; D001026:Coronary Artery Bypass; D004351:Drug Resistance / Q000235:genetics*; D005260:Female; D005787:Gene Frequency; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000235:genetics; D010597:Pharmacogenetics; D010974:Platelet Aggregation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D010979:Platelet Function Tests; D011110:Polymorphism, Genetic; D044244:Receptors, Thromboxane A2, Prostaglandin H2 / Q000235:genetics*; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D044244:Receptors, Thromboxane A2, Prostaglandin H2; D001241:Aspirin