Anti-aggregant therapy effectiveness among coronary heart disease patients in late post-bypass surgery period
Abstract
In 98 coronary heart disease (CHD) patients, who underwent complete myocardial revascularization, the effectiveness of anti-aggregant therapy with aspirin and thienopyridines, as well as cell hemostasis parameters, were evaluated in the first post-intervention year. Platelet aggregation was assessed with turbidimetric method, using ADP di-Na salt. Treatment effectiveness was assessed by end-points (death, myocardial infarction, recurrent angina, re-intervention). Statistical analysis was performed with Excel 7.0 program pack. Stable inhibition of platelet function was achieved with thienopyridine treatment. Low functional platelet activity was associated with reduced risk of adverse events in CHD patients who underwent bypass surgery, without significant difference between aspirin-sensitive and thienopyridine groups (p=0,176). Adverse event risk was increased in late post-intervention period among patients with normo- or hyper-aggregation cell hemostasis, who received aspirin monotherapy. Therefore, aspirin is effective for secondary prevention after bypass surgery, but its routine administration is not recommended when no cell hemostasis effect is observed.
About the Authors
O. F. Kardash
Республиканский научноJпрактический центр «Кардиология»
Belarus
Belarus
L. G. Gelis
Республиканский научноJпрактический центр «Кардиология»
Belarus
Belarus
I. V. Gugnina
Республиканский научноJпрактический центр «Кардиология»
Russian Federation
Russian Federation
Yu. P. Ostrovsky
Республиканский научноJпрактический центр «Кардиология»
Russian Federation
Russian Federation
References
1. Antithrombotic Trialists' Collaboration.//BMJ. 2002. Vol. 12, N. 324. P. 71-86.
2. Buchanan M.R., Schwartz L., Bourassa M. BRAT Investigators//Can J Cardiol. 2000. Vol. 16, N 11. P. 1385-1390.
3. Eikelboom J.W., Hirsh J., Weutz J.I., et al.//Circulation. 2002. Vol. 105, N 4. P. 1650-1655.
4. CAPRIE Steering Committee.//Lancet. 1996. Vol. 348. P. 1329-1339.
5. Cattaneo M.//Arterioscl Thromb Vasc Biol. 2004. Vol. 24. P. 1980-1987.
6. Gurbuz A.T., Zia A.A., Vuran A.C., et al.//Eur J. Cardio-Thor Surg. 2006. Vol. 29. P. 190-193.
7. Gum P.A., Kottke-Marchant K., Welsh P.A., et al.//J Amer Coll Cardiol. 2003. Vol. 41, N 6. P. 961-965.
8. The GUSTO Investigators.//N Engl J Med. 1993. V. 353. P. 673-682.
9. Kiss R.G., Stef G.Y., Kerecsen G., et al.//ESC Congress. 2004. Abstract 1400.
10. Mangano D.T.//N Engl J Med. 2002. Vol. 347. P. 1309-1317.
11. Pulcinelli F.M., Pignatelli P., Celestini A., et al.//J. American Coll. Cardiology. 2004. Vol. 43, N 6. P. 979-984.
12. Ruggeri Z.M.//Nat Med. 2002. Vol. 8. P. 1227-1234.
13. Shah P.J., Gordon I., Fuller J., et al.//J. Thor Cardiovasc Surg. 2003. Vol. 126. P. 1972-1977.
14. Stein P.D., Dalen J.E., Goldman S. et al.//Chest. 2001. Vol. 119. P. 278S-282S.
15. Zimmermann N., Kienzle P., Weber A.-A., et al.//J Thoracic Cardiovasc Surg. 2001. Vol. 121. P. 982-984.
Review
For citations:
Kardash O.F., Gelis L.G., Gugnina I.V., Ostrovsky Yu.P. Anti-aggregant therapy effectiveness among coronary heart disease patients in late post-bypass surgery period. Russian Journal of Cardiology. 2007;(2):72-76. (In Russ.)
Views:
800
Email this article 