Aspirin resistance after coronary artery bypass grafting

Zimmermann, Norbert; Kienzle, Peter; Weber, Artur‐Aron; Winter, Joachim; Gams, E.; Schrör, Karsten; Hohlfeld, Thomas

doi:10.1067/mtc.2001.111416

Cited by 95 publications

(89 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recent work from our laboratory has shown that the majority of patients who undergo coronary artery bypass grafting (CABG) develop aspirin resistance within the first 10 days after surgery. 9 Moreover, a metaanalysis of the Antiplatelet Trialist's Collaboration 10 indicated that patients after CABG do not benefit from antiplatelet (mostly aspirin) treatment.…”

mentioning

confidence: 99%

Functional and Biochemical Evaluation of Platelet Aspirin Resistance After Coronary Artery Bypass Surgery

et al. 2003

Self Cite

View full text Add to dashboard Cite

Background-Aspirin inhibits platelet activation and reduces atherothrombotic complications in patients at risk of myocardial infarction and stroke. However, a sufficient inhibition of platelet function by aspirin is not always achieved. The causes of this aspirin resistance are unknown. Methods and Results-Patients undergoing coronary artery bypass grafting (CABG) have a high incidence of aspirin resistance. To evaluate functional and biochemical responses to aspirin, platelet-rich plasma was obtained before and at days 1, 5, and 10 after CABG. Thromboxane formation, aggregation, and ␣-granule secretion were effectively inhibited by 30 or 100 mol/L aspirin in vitro before CABG, but this inhibition was prevented or attenuated after CABG. Whereas the inhibition of thromboxane formation and aggregation by aspirin in vitro partly recovered at day 10 after CABG, oral aspirin (100 mg/d) remained ineffective. The inducible isoform of cyclooxygenase in platelets, COX-2, has been suggested to confer aspirin resistance. In fact, immunoreactive COX-2 was increased 16-fold in platelets at day 5 after CABG, but the COX-2 selective inhibitor celecoxib did not alter aspirin-resistant thromboxane formation. By contrast, the combined inhibitor of thromboxane synthase and thromboxane receptor antagonist terbogrel equally prevented thromboxane formation of platelets obtained before (control) and after CABG. Conclusions-Platelet aspirin resistance involves an impairment of both in vivo and in vitro inhibition of platelet functions and is probably due to a disturbed inhibition of platelet COX-1 by aspirin. (Circulation. 2003;108:542-547.)

show abstract

mentioning

confidence: 99%

Functional and Biochemical Evaluation of Platelet Aspirin Resistance After Coronary Artery Bypass Surgery

et al. 2003

Self Cite

View full text Add to dashboard Cite

show abstract

“…Some study the prevalence of aspirin resistance and how to achieve defining its presence, [6][7][8] some study the mechanisms for aspirin resistance, [9][10][11][12] and yet others examine the impact or clin-ical significance of aspirin resistance on the presence or development of cardiovascular disease [13][14][15][16][17][18][19][20][21] (Table I). There is no consensus on the ideal technique for the assessment of the presence of aspirin resistance and therefore no agreement about a standardized definition.…”

Section: Discussionmentioning

confidence: 99%

“…These prostaglandins may promote aspirin resistance through platelet aggregation and vasoconstriction. 24,28 Clinical Implications of Aspirin Resistance Few long-term clinical studies have examined the clinical significance of aspirin resistance (Table I) 13,[15][16][17][19][20][21] Mueller et al 13 studied 100 patients undergoing peripheral balloon angioplasty and found that aspirin-resistant patients had an 87% higher risk of vascular reocclusion after 18 months. Sane et al 16 found an increased prevalence of aspirin resistance in patients post coronary artery bypass during their most vulnerable period, which was the first 5-10 days post surgery.…”

Section: Mechanisms Of Aspirin Resistancementioning

confidence: 99%

Aspirin resistance, an emerging, often overlooked, factor in the management of patients with coronary artery disease

Makaryus

2006

Clinical Cardiology

View full text Add to dashboard Cite

Summary:Aspirin is the most widely used medication in patients with cardiovascular disease. It has had a greater effect on patients with cardiovascular disease than any other drug. With the importance of aspirin now known for decades, it is recently becoming clearer that some patients do not derive as great a benefit from this "wonder drug" secondary to their resistance to its effects. Aspirin resistance, its prevalence, its identification, and how to overcome or avert it with other medications then becomes a central topic of discussion as important, if not more so, than the importance of aspirin itself as a cornerstone in the treatment of patients with cardiovascular disease. This review explores the current understanding of the mechanism of aspirin resistance with regard to its prevalence and the magnitude of its clinical significance. It also examines the therapeutic implications of a diagnosis of aspirin resistance.

show abstract

“…Aspirin (acetylsalicylic acid) is extensively used to inhibit platelet formation in this type of intervention, but up to 60% of the patients show some degree of resistance to aspirin. 123,124 In addition, it has been described that after CABG surgery there is an overexpression of the COX-2 gene, 125 and this could be the explanation for platelet formation in CABG patients. 126 In a study to elucidate the function of COX-2, an alternative spliced product was discovered, named COX-2a, and it was associated with CABG and platelet formation.…”

Section: Alternative Splicing In Drug Resistance Activation and Metamentioning

confidence: 99%

The impact of microRNAs and alternative splicing in pharmacogenomics

2009

View full text Add to dashboard Cite

Aspirin resistance after coronary artery bypass grafting

Cited by 95 publications

References 10 publications

Functional and Biochemical Evaluation of Platelet Aspirin Resistance After Coronary Artery Bypass Surgery

Functional and Biochemical Evaluation of Platelet Aspirin Resistance After Coronary Artery Bypass Surgery

Aspirin resistance, an emerging, often overlooked, factor in the management of patients with coronary artery disease

The impact of microRNAs and alternative splicing in pharmacogenomics

Contact Info

Product

Resources

About