Jan Hartinger1, Robert Novotny2, Jana Bilkova3, Tomas Kvasnicka3, Petr Mitas4, Martin Sima1, Jaroslav Hlubocky4, Jan Kvasnicka3, Ondrej Slanar1, Jaroslav Lindner4. 1. Department of Clinical Pharmacology and Pharmacy, Institute of Pharmacology, General University Hospital and 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic. 2. Transplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. 3. Thrombotic Centre, General University Hospital, Prague, Czech Republic. 4. 2nd Department of Cardiovascular Surgery, General University Hospital and 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
Abstract
OBJECTIVE: To evaluate the effects of dipyrone on sensitivity to aspirin (acetylsalicylic acid [ASA]) in patients who underwent peripheral artery vascular reconstruction. SUBJECTS AND METHODS: Impedance aggregometry and light transmission aggregometry were used to determine the effects of dipyrone on ASA treatment in 21 patients. Blood samples were drawn in a 7-day period after the surgery. The cut-off value for high on-treatment platelet reactivity (HTPR) was set at < 65% of aggregation inhibition for impedance aggregometry. For light transmission aggregometry the cut-off value for arachidonic acid-induced aggregation was set at > 20% of aggregating platelets, and the cut-off value for epinephrine-induced aggregation was > 44% of aggregating platelets. The cut-off value for each method was derived from a large number of patients treated with a daily dose of 100 mg of ASA. RESULTS: We found HTPR in 14 (67%) of the 21 patients. None had primary resistance to ASA, i.e., after the addition of ASA in vitro all samples showed antiplatelet efficacy. Regression analysis showed a possible correlation between lower efficacy of ASA treatment and higher daily doses of dipyrone (p = 0.005 for impedance aggregometry, p = 0.04 for light transmission aggregometry), higher platelet count (p = 0.005 for impedance aggregometry), and shorter time from surgery (p = 0.03 for impedance aggregometry). CONCLUSION: HTPR occurs in 67% of ASA-treated patients after lower limb vascular surgery. The occurrence of HTPR correlates with the daily dose of dipyrone. Therefore, dipyrone should not be used as a postoperative analgesic in ASA-treated patients after peripheral artery revascularisation due to its influence on the effectiveness of ASA.
OBJECTIVE: To evaluate the effects of dipyrone on sensitivity to aspirin (acetylsalicylic acid [ASA]) in patients who underwent peripheral artery vascular reconstruction. SUBJECTS AND METHODS: Impedance aggregometry and light transmission aggregometry were used to determine the effects of dipyrone on ASA treatment in 21 patients. Blood samples were drawn in a 7-day period after the surgery. The cut-off value for high on-treatment platelet reactivity (HTPR) was set at < 65% of aggregation inhibition for impedance aggregometry. For light transmission aggregometry the cut-off value for arachidonic acid-induced aggregation was set at > 20% of aggregating platelets, and the cut-off value for epinephrine-induced aggregation was > 44% of aggregating platelets. The cut-off value for each method was derived from a large number of patients treated with a daily dose of 100 mg of ASA. RESULTS: We found HTPR in 14 (67%) of the 21 patients. None had primary resistance to ASA, i.e., after the addition of ASA in vitro all samples showed antiplatelet efficacy. Regression analysis showed a possible correlation between lower efficacy of ASA treatment and higher daily doses of dipyrone (p = 0.005 for impedance aggregometry, p = 0.04 for light transmission aggregometry), higher platelet count (p = 0.005 for impedance aggregometry), and shorter time from surgery (p = 0.03 for impedance aggregometry). CONCLUSION: HTPR occurs in 67% of ASA-treated patients after lower limb vascular surgery. The occurrence of HTPR correlates with the daily dose of dipyrone. Therefore, dipyrone should not be used as a postoperative analgesic in ASA-treated patients after peripheral artery revascularisation due to its influence on the effectiveness of ASA.
Authors: Lisa Dannenberg; Vladimir Erschoff; Florian Bönner; Michael Gliem; Sebastian Jander; Bodo Levkau; Malte Kelm; Thomas Hohlfeld; Tobias Zeus; Amin Polzin Journal: Vascul Pharmacol Date: 2016-06-11 Impact factor: 5.773
Authors: J Papp; B Sandor; Z Vamos; D Botor; A Toth; M Rabai; P Kenyeres; P Cseplo; I Juricskay; E Mezosi; A Koller; K Toth Journal: Clin Hemorheol Microcirc Date: 2014 Impact factor: 2.375