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Single vs double antiplatelet therapy in acute coronary syndrome: Predictors of bleeding after coronary artery bypass grafting

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World Journal of Cardiology 2015年第9期7卷 571-578页

作者： Vincenzo Tarzia Giacomo Bortolussi Edward Buratto carla paolini Carlo Dal Lin Giulio Rizzoli Tomaso Bottio Gino Gerosa Division of Cardiac Surgery Department of Cardiac Thoracic and Vascular Sciences University of Padua Medical School Division of Cardiology Department of Cardiac Thoracic and Vascular Sciences University of Padua Medical School

AIM:To investigate the contribution of anti-platelet therapy and derangements of pre-operative classical coagulation and thromboelastometry parameters to major bleeding post-coronary artery bypass grafting(CABG).METHODS:Two groups of CABG patients were studied:Group A,treated with aspirin alone(n=50),and Group B treated with aspirin and clopidogrel(n=50).Both had similar preoperative,clinical,biologic characteristics and operative *** coagulation parameters and rotational thromboelastometry(ROTEM)profiles were determined preoperatively for both groups and the same heparin treatment was *** profiles(INTEM and EXTEM assays)were analyzed,both for traditional parameters,and thrombin generation potential,expressed by area-under-curve(AUC).RESULTS:There was no significant difference betweenrates of major bleeding between patients treated with aspirin alone,compared with those treated with aspirin and clopidogrel(12%vs 16%,P=0.77).In the 14 cases of major bleeding,pre-operative classic coagulation and traditional ROTEM parameters were *** we observed that the AUC in the EXTEM test was significantly lower in bleeders(5030±1115 Ohm*min)than non-bleeders(6568±548Ohm*min)(P<0.0001).CONCLUSION:We observed that patients with a low AUC value were at a significantly higher risk of bleeding compared to patients with higher AUC,regardless of antiplatelet *** suggests that thrombin generation potential,irrespective of the degree of platelet inhibition,correlates with surgical bleeding.

关键词： Platelet inhibitors Thromboelastometry Bleeding Ac

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