Coronary Artery Disease
Conditions
Keywords
preoperative aspirin use, platelet activation, off pump coronary artery bypass
Brief summary
Platelet activation after off pump coronary artery bypass (OPCAB) surgery may affect thrombus formation. The purpose of this study is to assess the effects of preoperative continuation of aspirin on platelet activation after off pump coronary artery bypass surgery.
Detailed description
Patients undergoing OPCAB surgery will be randomized to continue preoperative aspirin or discontinue aspirin before surgery. Platelet activation can be evaluated by measuring platelet p-selectin using flowcytometry. In this study, we will compare platelet-activated markers and conventional coagulation tests.
Interventions
Patients are randomized to continue aspirin before OPCAB surgery.
Patients are randomized to discontinue aspirin more than 4 days before OPCAB surgery.
Sponsors
Seoul National University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Masking
DOUBLE (Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* age : 20-80 * elective OPCAB * informed consent
Exclusion criteria
* coagulation disorder * emergency operation, re-operation * co-existing valvular disease * less than 6 months after cerebral vascular accident * heparin induced thrombocytopenia * heparin resistance * menstrual phase * preoperative cardiopulmonary bypass, continuous veno-veno hemofiltration, intra-aortic balloon pump application * less than 12 months after myocardiac infarction * less than 10 days after unstable angina * less than 30 days after percutaneous coronary intervention * less than 6 wks after bare metal stent insertion * less than 12 months after drug eluting stent insertion
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| change from baseline in platelet p-selectin at 48 hours after operation | after induction of anesthesia(baseline), at the time of end of operation, 24 hour after operation, 48hr after operation | Primary outcome is expression of platelet p-selectin measured by flowcytometry 48 hours after OPCAB surgery in both groups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| change from baseline in conventional coagulation tests at the time of end of operation, 24 hour after operation, and 48hr after operation | after induction of anesthesia(baseline), at the time of end of operation, 24 hour after operation, 48hr after operation | prothrombin time (international normalized ratio), activated partial thromboplastin time, fibrinogen |
Other
| Measure | Time frame | Description |
|---|---|---|
| change from baseline in platelet aggregation at the time of end of operation, 24 hour after operation, and 48hr after operation | after induction of anesthesia(baseline), at the time of end of operation, 24 hour after operation, 48hr after operation | prediction for stratification of bleeding risk due to antiplatelet agent using multiplate |
Countries
South Korea
Outcome results
None listed