Postoperative atrial fibrillation is associated with high on-aspirin platelet reactivity

Znanstveni rad - Izvorni znanstveni rad

• Autor: Tomislav Kopjar
• Autor: Mate Petričević
• Autor: Hrvoje Gašparović
• Autor: Lucija Svetina
• Autor: Davor Miličić
• Autor: Bojan Biočina
• Autorova ustanova: Sveučilište u Zagrebu; Medicinski fakultet
• Znanstveno / umjetničko područje, polje i grana: BIOMEDICINA I ZDRAVSTVO; Kliničke medicinske znanosti

Sažetak (engleski)

BACKGROUND:

Atrial fibrillation (AF) contributes to a prothrombotic state through platelet activation. It is unclear whether increased platelet aggregability in patients with AF is caused by the underlying cardiovascular condition rather than the arrhythmia per se. We investigated the effect of postoperative atrial fibrillation (POAF) on platelet reactivity after coronary artery bypass grafting (CABG). ----- METHODS:

This study is a post hoc analysis from a randomized controlled trial (ClinicalTrials.gov: NCT01159639) based on patients undergoing elective primary CABG. Patients were dichotomized according to POAF. Postoperative platelet function testing with arachidonic acid as the platelet agonist (ASPI test) was used to define high on-aspirin platelet reactivity (HAPR). ΔASPI presented the difference between pre- and postoperative ASPI test values. To account for the isolated effect of POAF on platelet reactivity, a propensity score analysis was applied. ----- RESULTS:

Overall incidence of POAF was 23% (92 of 398 patients). HAPR was detected in 54% (214 of 398) of patients. HAPR was more prevalent among patients with POAF when compared with patients without POAF (64.1% versus 50.7%; odds ratio [OR], 1.74; 95% confidence interval [CI], 1.08-2.82; p = 0.023). The propensity score model produced a subcohort of patients that was well balanced for comorbidities. When compared with the matched group without POAF, the POAF group maintained its prevalence for HAPR (64.1% versus 45.7%; OR, 2.13; 95% CI, 1.18-3.85; p = 0.012) and had greater ΔASPI values (15.0 [IQR, 0.0-36.0] vs 8.0 [IQR, -5.5-19.5]; p = 0.030). ----- CONCLUSIONS:

The main finding of our study indicates there is added platelet activation in patients with POAF after CABG before and after controlling for pathologic conditions through propensity matching. The present study does not prove a causal association between POAF and HAPR.

• Ključne riječi (engleski): Aged; Aspirin/administration & dosage; Atrial Fibrillation/blood; Atrial Fibrillation/etiology; Blood Platelets/drug effects; Coronary Artery Bypass/adverse effects; Coronary Artery Disease/blood; Coronary Artery Disease/surgery; Croatia/epidemiology; Dose-Response Relationship, Drug; Female; Follow-Up Studies; Humans; Incidence; Male; Middle Aged; Odds Ratio; Platelet Aggregation Inhibitors/administration & dosage; Postoperative Complications; Propensity Score; Retrospective Studies; Risk Factors
• Jezik: engleski
• Vrsta publikacije: Znanstveni rad - Izvorni znanstveni rad
• Status objave: Objavljen
• Vrsta recenzije: Recenziran
• Verzija publikacije: Završna verzija rukopisa prihvaćena za objavljivanje (postprint)
• Naslov časopisa: Annals of Thoracic Surgery
• Brojčani podaci: vol. 100, br. 5, str. 1704-1711
• p-ISSN: 0003-4975
• DOI: https://doi.org/10.1016/j.athoracsur.2015.05.001
• URN:NBN: urn:nbn:hr:105:932871
• Datum objave publikacije: 2015-11
• URL dokumenta: https://doi.org/10.1016/j.athoracsur.2015.05.001
• Vrsta resursa: Tekst
• Prava pristupa: Otvoreni pristup
• Datum i vrijeme pohrane: 2024-03-28 08:39:40