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Scientific paper - Original scientific paper
Definition of acetylsalicylic acid resistance using whole blood impedance aggregometry in patients undergoing coronary artery surgery
Collegium Antropologicum, 37 (2013), 3; 833-839. urn:nbn:hr:105:430464
Petričević, Mate; Biočina, Bojan; Konosić, Sanja; Burcar, Ivan; Širić, Franjo; Zrno Mihaljević, Martina; Ivančan, Višnja; Svetina, Lucija; Gašparović, Hrvoje

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Petričević, M., Biočina, B., Konosić, S., Burcar, I., Širić, F., Zrno Mihaljević, M. ... Gašparović, H. (2013). Definition of acetylsalicylic acid resistance using whole blood impedance aggregometry in patients undergoing coronary artery surgery . Collegium Antropologicum, 37. (3), 833-839. Retrieved from https://urn.nsk.hr/urn:nbn:hr:105:430464

Petričević, Mate, et al. "Definition of acetylsalicylic acid resistance using whole blood impedance aggregometry in patients undergoing coronary artery surgery ." Collegium Antropologicum, vol. 37, no. 3, 2013, pp. 833-839. https://urn.nsk.hr/urn:nbn:hr:105:430464

Petričević, Mate, Bojan Biočina, Sanja Konosić, Ivan Burcar, Franjo Širić, Martina Zrno Mihaljević, Višnja Ivančan, Lucija Svetina and Hrvoje Gašparović. "Definition of acetylsalicylic acid resistance using whole blood impedance aggregometry in patients undergoing coronary artery surgery ." Collegium Antropologicum 37, no. 3 (2013): 833-839. https://urn.nsk.hr/urn:nbn:hr:105:430464

Petričević, M., et al. (2013) 'Definition of acetylsalicylic acid resistance using whole blood impedance aggregometry in patients undergoing coronary artery surgery ', Collegium Antropologicum, 37(3), pp. 833-839. Available at: https://urn.nsk.hr/urn:nbn:hr:105:430464 (Accessed 06 November 2024)

Petričević M, Biočina B, Konosić S, Burcar I, Širić F, Zrno Mihaljević M, and sur.. Definition of acetylsalicylic acid resistance using whole blood impedance aggregometry in patients undergoing coronary artery surgery . Collegium Antropologicum [Internet]. 2013 September [cited 2024 November 06];37(3):833-839. Available at: https://urn.nsk.hr/urn:nbn:hr:105:430464

M. Petričević, et al., "Definition of acetylsalicylic acid resistance using whole blood impedance aggregometry in patients undergoing coronary artery surgery ", Collegium Antropologicum, vol. 37, no. 3, pp. 833-839, September 2013. [Online]. Available at: https://urn.nsk.hr/urn:nbn:hr:105:430464. [Accessed: 06 November 2024]

Metadata
Title (english)Definition of acetylsalicylic acid resistance using whole blood impedance aggregometry in patients undergoing coronary artery surgery
Title (croatian)Definicija rezistencije na acetilsalicilnu kiselinu upotrebom impedancijske agregometrije kod bolesnika koji se podvrgavaju operaciji koronarnog premoštenja
AuthorMate Petričević
AuthorBojan Biočina
AuthorSanja Konosić
AuthorIvan Burcar
AuthorFranjo Širić
AuthorMartina Zrno Mihaljević
AuthorVišnja Ivančan
AuthorLucija Svetina
AuthorHrvoje Gašparović
Author's institutionUniversity of Zagreb
School of Medicine
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Abstract (english)
A beneficial effect of acetylsalicylic acid (ASA) on vein graft patency has been described, but some patients experience adverse cardiac events despite appropriate ASA treatment. Study aim was to define ASA resistance using Multiple electrode aggregometry (MEA) preoperatively in group of patients undergoing coronary artery bypass grafting (CABG). Prospective observational trial at University Hospital Center Zagreb enrolled 131 patients scheduled for CABG, and divided them into 4 groups with respect to preoperative antiplatelet therapy (APT). Group 1 received 100 mg ASA per day, Group 2 100 mg ASA + 75 mg clopidogrel per day, Group 3 75 mg clopidogrel per day, and Group 4 did not receive any APT. MEA with ASPI test (sensitive to ASA) and ADP test (sensitive to clopidogrel) was performed prior to surgery. In Group 1, patients were characterized as ASA resistant if their ASPI test value exceeded the 75th percentile distribution. Study enrolled 131 patients. Significant differences both in the ASPI (p < 0.001) and the ADP test (p = 0.038) were observed between patients in different APT groups. In Group (1) ASPI test value of 30 AUC presented 75th percentile of distribution, thus indicating ASA resistance. Group 2 patients had slightly lower ADP test values, but no significant difference occurred (mean 60.05 vs. 63.32 AUC, p = 0.469). In Group 1 and 2, significant correlations between the ADP test and both, platelet count (r = 0.347, p < 0.001) and fibrinogen level (r = 0.364, p < 0.001) were observed. Association between low response to ASA and post-CABG major adverse ischemic events risk increase has been described thus indicating need for ASA resistant patients detection. In patients with preoperative ASPI test exceeding 30 AUC postoperative, ASA dose adjustment or clopidogrel addition according to MEA results should be considered.
Abstract (croatian)
Povoljan učinak acetilsalicilne kiseline na prohodnost venskih graftova već je opisana, ali određeni broj bolesnika poslijeoperacijski doživi nepovoljna ishemijska zbivanja unatoč adekvatnom liječenju acetilsalicilnom kiselinom. Cilj studije je prijeoperacijski definirati rezistenciju na acetilsalicilnu kiselinu upotrebom impedancijske agregometrije (MEA) u skupini bolesnika koji se podvrgavaju operaciji koronarnog premoštenja (CABG). Prospektivna opservacijska studija u Kliničkom bolničkom centru Zagreb uključila je 131 bolesnika kod kojih je planiran CABG. Bolesnici su podijeljeni u 4 skupine obzirom na prijeoperacijski ordiniranu antiagregacijsku terapiju. Skupina 1 je primala acetilsalicilnu kiselinu 100 mg/dnevno, skupina 2 100 mg acetilsalicilne kiseline te 75 mg klopidogrel dnevno, skupina 3 je primala klopidogrel 75 mg dnevno dok skupina 4 nije primala antiagregacijsku terapiju prije operacije. MEA s ASPI testom (koji je senzitivan na učinak acetilsalicilne kiseline) i ADP testom (senzitivan na učinak klopidogrela) je izvedena prije operacije. U skupini 1, bolesnici kojima je vrijednost ASPI testa iznosila vise od 75. percentile distribucije vrijednosti ASPI testa su okarakterizirani kao rezistentni na acetilsalicilnu kiselinu. Značajne razlike u vrijednostima ASPI (p<0.001) i ADP testa (p=0.038)uočene su između skupina bolesnika definiranih prema režimu prijeoperacijskog antiagregacijskog liječenja. U skupini 1, vrijednost ASPI testa od 30 AUC (engl. area under curve) je predstavljala vrijednost 75-te percentile, označavajući graničnu vrijednos za definiciju rezistencije na acetilsalicilnu kiselinu.U skupini 2 (izloženi klopidogrelu) izmjerene su niže vrijednosti ADP testa, međutim bez statistički značajne razlike (srednja vrijednost 60.05 vs. 63.32 AUC, p=0.469). U skupini 1 i 2,uočene su značajne korelacije između vrijednosti ADP testa i broja trombocita (r=0.347, p<0.001) te razine fibrinogena (r=0.364, p<0.001).Povezanost između izostanka odgovora na acetilsalicilnu kiselinu i povećanog rizika za neželjena poslijeoperacijska ishemijska zbivanja je već opisana što naglašava potrebu za brzim i lakoizvedivim definiranjem bolesnika s rezistencijom na acetilsalicilnu kiselinu. Kod bolesnika s prijeoperacijskim vrijednostima ASPI testa većim od 30 AUC, trebalo bi razmotriti prilagodbu doze acetilsalicilne kiseline ili dodavanje klopidogrela (tzv. dvojna antiagregacijska terapija) na osnovi MEA monitoriranja.
Keywords (english)
Languageenglish
Publication typeScientific paper - Original scientific paper
Publication statusPublished
Peer reviewPeer review
Publication versionPublished version
Journal titleCollegium Antropologicum
Numberingvol. 37, no. 3, pp. 833-839
p-ISSN0350-6134
URN:NBNurn:nbn:hr:105:430464
Publication2013-09
Document URLhttps://hrcak.srce.hr/118278
Type of resourceText
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2024-03-27 20:13:13