Filiz ALKAYA SOLMAZ, Kenan Abdurrahman KARA, İlker KİRİŞ, Hayrettin ÖZKAN, Hüseyin OKUTAN, Şenol GÜLMEN

Koroner arter bypass cerrahisi sonrası erken dönemde aspirin direnci gelişme sıklığı ve tromboksan A2 üretiminin yetersiz inhibisyonu

Amaç: Bu çalışmada koroner arter bypass greft cerrahisi uygulanan hastalarda ameliyat sonrası erken dönemde aspirin direnci gelişme sıklığı ve bu direncin geri dönüşümlü olup olmadığı araştırıldı ve ameliyat sonrası erken dönemde aspirin direnci gelişmesinde tromboksan A2 üretiminin yetersiz inhibisyonu mekanizmasının etkinliği değerlendirildi. Çalışma planı: Şubat 2009 - Mart 2010 tarihleri arasında kliniğimizde koroner arter bypass greft cerrahisi yapılan 80 hasta (55 erkek, 25 kadın; ort. yaş 63.1±9.2 yıl; dağılım 51 to 75 yıl) prospektif olarak değerlendirildi. Ameliyat öncesi ve ameliyat sonrası yedinci ve on beşinci günlerde hastalardan alınan venöz kan örnekleri trombosit fonksiyon cihazı ile değerlendirildi. Aspirin direnci tanısı kollajen-epinefrin kapanma zamanının 186 sn’den düşük olması durumu olarak tanımlandı. Ameliyat sonrası birinci gün alınan idrar örneklerinde 11-dehidro tromboksan B2 düzeyleri ölçüldü. Bulgular: Ameliyat öncesi dönemde 23 hastada (%28.75), ameliyat sonrası yedinci günde 31 hastada (%38.75) ve 15. günde 25 hastada (%31.25) aspirin direnci saptandı. Ameliyat sonrası yedinci günde aspirin direnci olan hastalardaki 11-dehidro tromboksan B2 düzeyi, aspirin direnci olmayan hastalardaki düzeylere göre anlamlı derecede daha yüksekti (p

Frequency of development of aspirin resistance in the early postoperative period and inadequate inhibition of thromboxane A2 production after coronary artery bypass surgery

Background: This study aims to investigate the frequency of the developmentof aspirin resistance, whether or not this resistance was reversible, andto evaluate the efficiency of the mechanism of incomplete inhibition ofthromboxane A2 in development of aspirin resistance in the early postoperativeperiod in patients who had undergone coronary artery bypass grafting.Methods: Eighty patients (55 males, 25 females; mean age 63.1±9.2 years;range 51 to 75 years) who underwent coronary artery bypass grafting betweenFebruary 2009 and March 2010 at our clinic were prospectively evaluated.Venous blood samples were collected from all patients and evaluated by a plateletfunction analyzer in the preoperative period and on postoperative days 7 and 15.Aspirin resistance diagnosis was defined as collagen-epinephrine closure timeless than 186 seconds. The urine levels of 11-dehidro thromboxane B2 were alsomeasured on postoperative day one.Results: Aspirin resistance was found in 23 patients (28.75%) in thepreoperative period, in 31 patients (38.75%) on the postoperative seventh dayand in 25 patients (31.25%) on the postoperative 15th day. The urine levelsof 11-dehidro thromboxane B2 in patients with aspirin resistance on thepostoperative seventh day were significantly higher than those in patientswithout aspirin resistance (p

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