Relationship between high on aspirin platelet reactivity and oxidative stress in coronary artery by-pass grafted patients

Blood Coagul Fibrinolysis. 2016 Mar;27(2):151-5. doi: 10.1097/MBC.0000000000000396.

Abstract

The aim of the study was to assess the responsiveness of blood platelets to acetylsalicylic acid (ASA) in patients following coronary artery bypass grafting (CABG) surgery with relation to oxidative and antioxidative plasma status. The study included 37 patients treated with the CABG procedure. During the first 24 h after CABG patients were given 300 mg of ASA with the following dose of 150 mg daily. The blood was collected before the procedure and 10 days after. Whole blood platelet aggregation induced with arachidonic acid, collagen and adenosine diphosphate (ADP) was performed together with whole blood generation of thromboxane B2 (TxB2). Oxidative stress was measured before and 10 days after CABG with total oxidative plasma status (TOS) and total antioxidative status of the plasma (TAS). TOS/TAS index was calculated. We observed a significant increase in the TOS and TOS/TAS index and ADP-induced aggregation 10 days after CABG in comparison with its level before operation. There was a significant decrease in the arachidonic acid-induced aggregation and serum TxB2 level. Patients with ADP-induced and collagen-induced aggregation in the upper quartile had significantly higher TOS and TOS/TAS index before (ADP) and after the operation (ADP and collagen). There were 19 patients (51%) with high on aspirin platelet reactivity after CABG who had also higher TOS and TOS/TAS index and lower TAS value in comparison with aspirin responders. Despite ASA use, increased oxidative stress after CABG can overcome its antiplatelet effect and increase platelet activation through other pathways.

MeSH terms

  • Adenosine Diphosphate / pharmacology
  • Aged
  • Arachidonic Acid / antagonists & inhibitors
  • Arachidonic Acid / pharmacology
  • Aspirin / pharmacology*
  • Blood Platelets / drug effects*
  • Blood Platelets / metabolism
  • Blood Platelets / pathology
  • Collagen / antagonists & inhibitors
  • Collagen / pharmacology
  • Coronary Artery Bypass*
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / pathology
  • Coronary Artery Disease / surgery*
  • Coronary Vessels / metabolism
  • Coronary Vessels / pathology
  • Drug Administration Schedule
  • Female
  • Humans
  • Male
  • Middle Aged
  • Oxidative Stress
  • Platelet Aggregation / drug effects
  • Platelet Aggregation Inhibitors / pharmacology*
  • Thromboxane B2 / blood

Substances

  • Platelet Aggregation Inhibitors
  • Arachidonic Acid
  • Thromboxane B2
  • Adenosine Diphosphate
  • Collagen
  • Aspirin