The publication detail shows the title, authors (with indicators showing other profiled authors), information on the publishing organization, abstract and a link to the article in PubMed. This abstract is what is used to create the fingerprint of the publication. If any grants are referenced by the publication, they will be listed here as well.
Perioperative management of aspirin resistance after off-pump coronary artery bypass grafting: possible role for aprotinin.
Robert S Poston; Junyan Gu; Charles White; Jean Jeudy; Lei Nie; James Brown; James Gammie; Richard N Pierson; Linda Romar; Bartley P Griffith (Profiled Authors: James S Gammie; Bartley P Griffith; Jean Jeudy Jr; Richard N Pierson III; Charles S White)
Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA. firstname.lastname@example.org
Transfusion 2008;48(1 Suppl):39S-46S.
BACKGROUND: Aspirin is the only drug proven to reduce saphenous vein graft (SVG) failure, but aspirin resistance (ASA-R) frequently occurs after off-pump coronary artery bypass grafting (OPCAB). The factors, mechanism, and best means for preventing and/or treating ASA-R have not been established. This study hypothesizes that thrombin production during OPCAB stimulates this acquired ASA-R. STUDY DESIGN AND METHODS: A nonrandomized prospective cohort of 255 patients (n=465 SVG) who underwent OPCAB with varied use of aprotinin (21%) and different SVG preparation techniques (standard, 56% vs. low-pressure, 44%) was analyzed. A surplus SVG segment was obtained to assess endothelial integrity. ASA-R was determined at baseline, after surgery, and on Days 1 and 3 by three assays. The effects of aprotinin on thrombin responsiveness were analyzed by means of whole-blood aggregometry, SVG tissue factor (TF) activity, and transcardiac thrombin production (i.e., F1.2 levels in aorta versus coronary sinus). SVG patency was assessed on Day 5 with multichannel CT angiography. RESULTS: ASA-R developed in 42 percent of patients after OPCAB. Multivariate analysis showed that ASA-R, endothelial integrity, and target size independently predicted early SVG failure. Aprotinin use was associated with: 1) reduced postoperative ASA-R (15%); 2) decreased platelet (PLT) response to thrombin; 3) reduced TF activity within SVG segments; 4) decreased transcardiac thrombin gradient; and 5) improved SVG patency. CONCLUSION: ASA-R is a common post-OPCAB event whose frequency may be reduced by intraoperative use of aprotinin, possibly via TF and thrombin suppression. Improved perioperative PLT function after OPCAB may also inadvertently enhance the clinical relevance of these potential antithrombotic effects.
This section shows information related to the publication - computed using the fingerprint of the publication - including related publications, related experts and related grants with fingerprints representing significant amounts of overlap between their fingerprint and this publication. The red dots indicate whether those experts or terms appear within the publication, thereby showing potential and actual connections.
Robert S Poston; Charles White; Junyan Gu; James Brown; James Gammie; Richard N Pierson; Andrew Lee; Ingrid Connerney; Thrity Avari; Robert Christenson; et al.The Annals of thoracic surgery 2006;81(1):104-10; discussion 110-1.
Robert S Poston; Junyan Gu; James M Brown; James S Gammie; Charles White; Lei Nie; Richard N Pierson; Bartley P GriffithThe Journal of thoracic and cardiovascular surgery 2006;131(1):122-30.
Pranjal H Desai; Dinesh Kurian; Nannan Thirumavalavan; Sneha P Desai; Pluen Ziu; Michael Grant; Charles White; R Clive Landis; Robert S PostonAnesthesia and analgesia 2009;109(5):1387-94.
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