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The Pre- and Postoperative Prevalence and Risk Factors of ASA Nonresponse in Vascular Surgery.
Kazimi, Alia Uzra; Weber, Christian Friedrich; Keese, Michael; Miesbach, Wolfgang.
Afiliación
  • Kazimi AU; Sana Klinikum Offenbach, Medical Clinic I, 9206Internal Intensive Care Medicine and General Medicine, Offenbach, Germany.
  • Weber CF; 39482Asklepios Klinik Wandsbek, Intensive Care Medicine and Emergency Medicine, Hamburg, Germany.
  • Keese M; University Hospital Mannheim, Mannheim, Germany.
  • Miesbach W; Hemophilia Centre, 14984University Hospital Frankfurt, Medical Clinic II, Institute of Transfusion Medicine and Immunhematology, Frankfurt, Germany.
Clin Appl Thromb Hemost ; 27: 10760296211044723, 2021.
Article en En | MEDLINE | ID: mdl-34609920
BACKGROUND: An antiplatelet therapy with acetylsalicylic acid (ASA) is prescribed in the prevention of cardiovascular events, but around 24% of ASA takers are resistant to the treatment. AIM: In this prospective, observational cohort study, we aimed to identify the prevalence and risk factors of ASA nonresponse in patients who underwent vascular surgery. METHODS: The study was conducted in the University hospital in Frankfurt am Main. In total, 70 patients were pre-treated with 100 mg of ASA per day and underwent either elective carotid thromboendarterectomy, femoral thromboendarterectomy or endovascular aneurysm repair of the abdominal aorta. The platelet function was measured on the first preoperative and the second or fourth postoperative day with the multiple electrode aggregometry by in-vitro stimulation with arachidonic acid (ASPItest) and thrombin receptor activating peptide 6 (TRAPtest). The primary end point was the in-vitro induced platelet aggregation in the ASPItest. If the ASPItest amounted ≥400 AU × min, the patients were categorized as ASA nonresponders. RESULTS: The total prevalence of ASA nonresponse in our study was 20% preoperatively and 35.7% postoperatively (p = 0.005). As significant predictors for ASA nonresponse, we demonstrated the area under the aggregation curve in the TRAPtest preoperatively (p = 0.04) and postoperatively (p = 0.02), and the two comorbidities arterial hypertension (P < .001; rho 0.44) and diabetes mellitus (p = 0.04; rho 0.39), which are already well known to be associated with ASA nonresponse. CONCLUSION: In conclusion, data of the study indicate a high incidence of perioperative, laboratory ASA nonresponse in patients undergoing vascular surgery.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos Vasculares / Agregación Plaquetaria / Aspirina Tipo de estudio: Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Clin Appl Thromb Hemost Asunto de la revista: ANGIOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos Vasculares / Agregación Plaquetaria / Aspirina Tipo de estudio: Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Clin Appl Thromb Hemost Asunto de la revista: ANGIOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos