Document Detail


Effects of aspirin and desmopressin on platelet reactivity in patients undergoing cardiac surgery with extracorporeal circulation.
MedLine Citation:
PMID:  21057697     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The effect of desmopressin on platelet function in patients with continued antiplatelet therapy undergoing cardiac surgery is discussed controversially. We assessed platelet reactivity in 86 patients undergoing elective coronary artery bypass grafting (CABG) under extracorporeal circulation. Twenty-nine of these patients were without preoperative antiplatelet therapy (group A), while 57 were treated with acetylsalicylic acid (ASA) 100 mg qd up to the day of surgery. Out of this cohort, 24 patients received no desmopressin perioperatively (group B), whereas 33 patients were treated with desmopressin 0.4 microg/kg after administration of protamine due to increased bleeding tendency (group C). Multiple electrode platelet aggregometry with arachidonic acid as agonist showed a marked decrease of platelet reactivity in patients without antiplatelet therapy immediately after extracorporeal circulation compared to preoperative control (375 ± 227 vs. 749 ± 330 AU*min, p<0.001). Platelet reactivity recovered to preoperative controls in group A at 24 hours after protamine administration (662 ± 295 AU*min). Platelet reactivity in patients on ASA was not decreased further after extracorporeal circulation (group B: 197 ± 126 vs. 251 ± 203 AU*min, p=0.14; group C: 212 ± 100 vs. 245 ± 248 AU*min, p=0.43) and improved significantly within 24 hours. A statistically significant effect of desmopressin, however, could not be determined (group B: 392 ± 223 AU*min; group C: 439 ± 324 AU*min at 24 hours after protamine, p=0.63 for between-subjects contrast). Our data suggest that desmopressin does not affect platelet reactivity in patients on ASA undergoing CABG and is, therefore, not useful in this clinical setting.
Authors:
Cornelius Keyl; Eliane Kmitta; Ssmi Kueri; Tomasz Zietak; Dietmar Trenk
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article     Date:  2010-11-05
Journal Detail:
Title:  Thrombosis and haemostasis     Volume:  105     ISSN:  0340-6245     ISO Abbreviation:  Thromb. Haemost.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-04     Completed Date:  2011-05-18     Revised Date:  2011-05-23    
Medline Journal Info:
Nlm Unique ID:  7608063     Medline TA:  Thromb Haemost     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  113-21     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology, Heart Centre Bad Krozingen, Bad Krozingen, Germany. cornelius.keyl@herzzentrum.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Aspirin / administration & dosage,  pharmacology*
Blood Platelets / drug effects
Cardiac Surgical Procedures / methods*
Coronary Artery Bypass / methods*
Deamino Arginine Vasopressin / administration & dosage,  pharmacology*
Female
Hemostatics
Humans
Male
Middle Aged
Platelet Activation / drug effects*
Platelet Aggregation Inhibitors
Protamines / administration & dosage
Chemical
Reg. No./Substance:
0/Hemostatics; 0/Platelet Aggregation Inhibitors; 0/Protamines; 16679-58-6/Deamino Arginine Vasopressin; 50-78-2/Aspirin

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