This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rahe-Meyer, N. Articles by Solomon, C. Search for Related Content PubMed PubMed Citation Articles by Rahe-Meyer, N. Articles by Solomon, C. Related Collections Cardiovascular Preoperative Evaluation Coagulation Pharmacology

---

CARDIOVASCULAR ANESTHESIOLOGY

An Evaluation of Cyclooxygenase-1 Inhibition Before Coronary Artery Surgery: Aggregometry Versus Patient Self-Reporting

Niels Rahe-Meyer, MD, PhD^*, Michael Winterhalter, MD^*, Julia Hartmann^*, Albert Pattison, Hartmut Hecker, Andreas Calatzis, MD, and Cristina Solomon, MD^*

From the *Department of Anesthesiology, Hannover Medical School, Hannover, Germany; Hart Biologicals, Hartlepool, UK; Institute for Biometry, Hannover Medical School, Hannover, Germany; and Department of Hemostasis and Transfusion Medicine, University Hospital Munich, Munich, Germany.

Address correspondence and reprint requests to Dr. Niels Rahe-Meyer, Department of Anesthesiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Address e-mail to rahe-meyer.niels{at}mh-hannover.de.

Abstract

BACKGROUND: Platelet dysfunction due to antiplatelet therapy contributes to perioperative bleeding. Several trials investigating the influence of aspirin intake within the 5 days before surgery reported that transfusion requirements were either increased or not significantly affected by aspirin intake. Our objective was to compare the assessment of aspirin intake by patient self-reporting and by measurement of platelet function with regard to transfusion requirements.

METHODS: In a prospective trial, a standardized questionnaire was used in 100 patients for aspirin intake within the 5 days immediately before coronary artery bypass grafting. Whole blood platelet aggregation triggered by arachidonic acid was investigated using the Multiplate® platelet function analyzer.

RESULTS: Eleven of 23 patients with aspirin intake within the 5 days before the intervention showed an abnormal aggregation response. Nine of 77 patients who reported no aspirin intake before surgery had an abnormal aggregation response. There were no significant differences in chest tube drainage and red blood cell transfusion over the first 24 h postoperatively between patients with and without reported aspirin intake. There was no significant difference in chest tube drainage over the first 24 h postoperatively between patients showing normal or abnormal aggregation response. Patients with abnormal aggregation before intervention (<51 U) received significantly more platelet transfusion than patients with normal aggregation (1.1 U compared to 0.3 U, P = 0.001).

CONCLUSIONS: Our results suggest that arachidonic acid-induced aggregation in whole blood may be a better predictor of platelet-related coagulopathy and platelet transfusion than the assessment of aspirin intake by patient self-reporting.

This article has been cited by other articles:

				C. Jambor, C. F. Weber, K. Gerhardt, W. Dietrich, M. Spannagl, B. Heindl, and B. Zwissler Whole Blood Multiple Electrode Aggregometry Is a Reliable Point-of-Care Test of Aspirin-Induced Platelet Dysfunction Anesth. Analg., July 1, 2009; 109(1): 25 - 31. [Abstract] [Full Text] [PDF]

				R. Paniccia, E. Antonucci, N. Maggini, E. Romano, A. M. Gori, R. Marcucci, D. Prisco, and R. Abbate Assessment of Platelet Function on Whole Blood by Multiple Electrode Aggregometry in High-Risk Patients With Coronary Artery Disease Receiving Antiplatelet Therapy Am J Clin Pathol, June 1, 2009; 131(6): 834 - 842. [Abstract] [Full Text] [PDF]