The role of unfractionated heparin for the antiaggregatory effect of aspirin in patients undergoing carotid endarterectomy: Results of an observational clinical study
The aims of the present study were to examine the influence of a low-dose unfractionated heparin regime on platelet aggregation and to additionally assess the prevalence of primary aspirin resistance in patients undergoing carotid endarterectomy. Therefore, 50 patients undergoing carotid endarterect...
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| Veröffentlicht in: | Vascular 2017-02, Vol.25 (1), p.19-27 |
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| creator | Brenner, Thorsten Schmitt, Felix CF Demirel, Serdar Salgado, Eduardo Celi de la Torre, Juan Antonio Göring, Martin Bruckner, Thomas Böckler, Dittmar Weigand, Markus A Hofer, Stefan Attigah, Nicolas |
| description | The aims of the present study were to examine the influence of a low-dose unfractionated heparin regime on platelet aggregation and to additionally assess the prevalence of primary aspirin resistance in patients undergoing carotid endarterectomy. Therefore, 50 patients undergoing carotid endarterectomy were enrolled. A bolus of 3000 IU unfractionated heparin was administered 2 min before carotid cross-clamping additionally to standard antiaggregatory therapy. Haemostaseological point of care testing was performed twice, prior to surgery and 10 min after unfractionated heparin administration by the use of aggregometric and viscoelastic point of care testing. Following unfractionated heparin administration, the activated partial thromboplastin time increased significantly and clotting time in viscoelastic INTEM test was shown to be significantly prolonged. In contrast, the antiaggregatory effect of aspirin was not diminished in aggregometric ASPI test. A low-dose unfractionated heparin regime during carotid endarterectomy was therefore considered to be safe, without diminishing the antiplatelet effect of aspirin. Moreover, aggregometric point of care testing was identified to be a suitable tool for the identification of patients with primary aspirin resistance (n = 3). |
| doi_str_mv | 10.1177/1708538116638961 |
| format | Article |
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Therefore, 50 patients undergoing carotid endarterectomy were enrolled. A bolus of 3000 IU unfractionated heparin was administered 2 min before carotid cross-clamping additionally to standard antiaggregatory therapy. Haemostaseological point of care testing was performed twice, prior to surgery and 10 min after unfractionated heparin administration by the use of aggregometric and viscoelastic point of care testing. Following unfractionated heparin administration, the activated partial thromboplastin time increased significantly and clotting time in viscoelastic INTEM test was shown to be significantly prolonged. In contrast, the antiaggregatory effect of aspirin was not diminished in aggregometric ASPI test. A low-dose unfractionated heparin regime during carotid endarterectomy was therefore considered to be safe, without diminishing the antiplatelet effect of aspirin. Moreover, aggregometric point of care testing was identified to be a suitable tool for the identification of patients with primary aspirin resistance (n = 3).</description><identifier>ISSN: 1708-5381</identifier><identifier>EISSN: 1708-539X</identifier><identifier>DOI: 10.1177/1708538116638961</identifier><identifier>PMID: 26993144</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Aged ; Aged, 80 and over ; Anticoagulants - administration & dosage ; Anticoagulants - adverse effects ; Aspirin - adverse effects ; Aspirin - therapeutic use ; Blood Coagulation - drug effects ; Blood Coagulation Tests ; Carotid Artery Diseases - blood ; Carotid Artery Diseases - diagnostic imaging ; Carotid Artery Diseases - surgery ; Drug Resistance ; Endarterectomy, Carotid - adverse effects ; Female ; Heparin - administration & dosage ; Heparin - adverse effects ; Humans ; Male ; Middle Aged ; Platelet Aggregation - drug effects ; Platelet Aggregation Inhibitors - adverse effects ; Platelet Aggregation Inhibitors - therapeutic use ; Platelet Function Tests ; Point-of-Care Testing ; Predictive Value of Tests ; Prospective Studies ; Treatment Outcome</subject><ispartof>Vascular, 2017-02, Vol.25 (1), p.19-27</ispartof><rights>The Author(s) 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-899f723b0ebe2cc54935eaae251251cb4353d1ed992079e6fdbeca58a6b353603</citedby><cites>FETCH-LOGICAL-c337t-899f723b0ebe2cc54935eaae251251cb4353d1ed992079e6fdbeca58a6b353603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1708538116638961$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1708538116638961$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21799,27903,27904,43600,43601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26993144$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brenner, Thorsten</creatorcontrib><creatorcontrib>Schmitt, Felix CF</creatorcontrib><creatorcontrib>Demirel, Serdar</creatorcontrib><creatorcontrib>Salgado, Eduardo</creatorcontrib><creatorcontrib>Celi de la Torre, Juan Antonio</creatorcontrib><creatorcontrib>Göring, Martin</creatorcontrib><creatorcontrib>Bruckner, Thomas</creatorcontrib><creatorcontrib>Böckler, Dittmar</creatorcontrib><creatorcontrib>Weigand, Markus A</creatorcontrib><creatorcontrib>Hofer, Stefan</creatorcontrib><creatorcontrib>Attigah, Nicolas</creatorcontrib><title>The role of unfractionated heparin for the antiaggregatory effect of aspirin in patients undergoing carotid endarterectomy: Results of an observational clinical study</title><title>Vascular</title><addtitle>Vascular</addtitle><description>The aims of the present study were to examine the influence of a low-dose unfractionated heparin regime on platelet aggregation and to additionally assess the prevalence of primary aspirin resistance in patients undergoing carotid endarterectomy. Therefore, 50 patients undergoing carotid endarterectomy were enrolled. A bolus of 3000 IU unfractionated heparin was administered 2 min before carotid cross-clamping additionally to standard antiaggregatory therapy. Haemostaseological point of care testing was performed twice, prior to surgery and 10 min after unfractionated heparin administration by the use of aggregometric and viscoelastic point of care testing. Following unfractionated heparin administration, the activated partial thromboplastin time increased significantly and clotting time in viscoelastic INTEM test was shown to be significantly prolonged. In contrast, the antiaggregatory effect of aspirin was not diminished in aggregometric ASPI test. A low-dose unfractionated heparin regime during carotid endarterectomy was therefore considered to be safe, without diminishing the antiplatelet effect of aspirin. Moreover, aggregometric point of care testing was identified to be a suitable tool for the identification of patients with primary aspirin resistance (n = 3).</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anticoagulants - administration & dosage</subject><subject>Anticoagulants - adverse effects</subject><subject>Aspirin - adverse effects</subject><subject>Aspirin - therapeutic use</subject><subject>Blood Coagulation - drug effects</subject><subject>Blood Coagulation Tests</subject><subject>Carotid Artery Diseases - blood</subject><subject>Carotid Artery Diseases - diagnostic imaging</subject><subject>Carotid Artery Diseases - surgery</subject><subject>Drug Resistance</subject><subject>Endarterectomy, Carotid - adverse effects</subject><subject>Female</subject><subject>Heparin - administration & dosage</subject><subject>Heparin - adverse effects</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Platelet Aggregation - drug effects</subject><subject>Platelet Aggregation Inhibitors - adverse effects</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Platelet Function Tests</subject><subject>Point-of-Care Testing</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Treatment Outcome</subject><issn>1708-5381</issn><issn>1708-539X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUFr3DAQhUVpaNK0956Cjr24lay1bPVWQpoUAoWygd7MWBp5FbySI8mF_UP9nZW72xwKhYEZNN97A3qEvOPsA-dt-5G3rGtEx7mUolOSvyAX61PVCPXj5fPc8XPyOqVHxgSruXxFzmuplOCbzQX5td0hjWFCGixdvI2gswseMhq6wxmi89SGSHPBwGcH4xhxhBzigaK1qPMqhDS7lSw1Q3bocypmBuMYnB-phhiyMxS9gZgxFlXYHz7R75iWqaCrg6dhSBh_wp_zE9WT806XIeXFHN6QMwtTwrenfkkevtxsr--q-2-3X68_31daiDZXnVK2rcXAcMBa62ajRIMAWDe8lB42ohGGo1GqZq1Cac2AGpoO5FA2kolL8v7oO8fwtGDK_d4ljdMEHsOSet7VUkrW1l1B2RHVMaQU0fZzdHuIh56zfk2n_zedIrk6uS_DHs2z4G8cBaiOQIIR-8ewxPIV6f-GvwFTTZvf</recordid><startdate>201702</startdate><enddate>201702</enddate><creator>Brenner, Thorsten</creator><creator>Schmitt, Felix CF</creator><creator>Demirel, Serdar</creator><creator>Salgado, Eduardo</creator><creator>Celi de la Torre, Juan Antonio</creator><creator>Göring, Martin</creator><creator>Bruckner, Thomas</creator><creator>Böckler, Dittmar</creator><creator>Weigand, Markus A</creator><creator>Hofer, Stefan</creator><creator>Attigah, Nicolas</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201702</creationdate><title>The role of unfractionated heparin for the antiaggregatory effect of aspirin in patients undergoing carotid endarterectomy: Results of an observational clinical study</title><author>Brenner, Thorsten ; Schmitt, Felix CF ; Demirel, Serdar ; Salgado, Eduardo ; Celi de la Torre, Juan Antonio ; Göring, Martin ; Bruckner, Thomas ; Böckler, Dittmar ; Weigand, Markus A ; Hofer, Stefan ; Attigah, Nicolas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-899f723b0ebe2cc54935eaae251251cb4353d1ed992079e6fdbeca58a6b353603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anticoagulants - administration & dosage</topic><topic>Anticoagulants - adverse effects</topic><topic>Aspirin - adverse effects</topic><topic>Aspirin - therapeutic use</topic><topic>Blood Coagulation - drug effects</topic><topic>Blood Coagulation Tests</topic><topic>Carotid Artery Diseases - blood</topic><topic>Carotid Artery Diseases - diagnostic imaging</topic><topic>Carotid Artery Diseases - surgery</topic><topic>Drug Resistance</topic><topic>Endarterectomy, Carotid - adverse effects</topic><topic>Female</topic><topic>Heparin - administration & dosage</topic><topic>Heparin - adverse effects</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Platelet Aggregation - drug effects</topic><topic>Platelet Aggregation Inhibitors - adverse effects</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>Platelet Function Tests</topic><topic>Point-of-Care Testing</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brenner, Thorsten</creatorcontrib><creatorcontrib>Schmitt, Felix CF</creatorcontrib><creatorcontrib>Demirel, Serdar</creatorcontrib><creatorcontrib>Salgado, Eduardo</creatorcontrib><creatorcontrib>Celi de la Torre, Juan Antonio</creatorcontrib><creatorcontrib>Göring, Martin</creatorcontrib><creatorcontrib>Bruckner, Thomas</creatorcontrib><creatorcontrib>Böckler, Dittmar</creatorcontrib><creatorcontrib>Weigand, Markus A</creatorcontrib><creatorcontrib>Hofer, Stefan</creatorcontrib><creatorcontrib>Attigah, Nicolas</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Vascular</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brenner, Thorsten</au><au>Schmitt, Felix CF</au><au>Demirel, Serdar</au><au>Salgado, Eduardo</au><au>Celi de la Torre, Juan Antonio</au><au>Göring, Martin</au><au>Bruckner, Thomas</au><au>Böckler, Dittmar</au><au>Weigand, Markus A</au><au>Hofer, Stefan</au><au>Attigah, Nicolas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of unfractionated heparin for the antiaggregatory effect of aspirin in patients undergoing carotid endarterectomy: Results of an observational clinical study</atitle><jtitle>Vascular</jtitle><addtitle>Vascular</addtitle><date>2017-02</date><risdate>2017</risdate><volume>25</volume><issue>1</issue><spage>19</spage><epage>27</epage><pages>19-27</pages><issn>1708-5381</issn><eissn>1708-539X</eissn><abstract>The aims of the present study were to examine the influence of a low-dose unfractionated heparin regime on platelet aggregation and to additionally assess the prevalence of primary aspirin resistance in patients undergoing carotid endarterectomy. Therefore, 50 patients undergoing carotid endarterectomy were enrolled. A bolus of 3000 IU unfractionated heparin was administered 2 min before carotid cross-clamping additionally to standard antiaggregatory therapy. Haemostaseological point of care testing was performed twice, prior to surgery and 10 min after unfractionated heparin administration by the use of aggregometric and viscoelastic point of care testing. Following unfractionated heparin administration, the activated partial thromboplastin time increased significantly and clotting time in viscoelastic INTEM test was shown to be significantly prolonged. In contrast, the antiaggregatory effect of aspirin was not diminished in aggregometric ASPI test. A low-dose unfractionated heparin regime during carotid endarterectomy was therefore considered to be safe, without diminishing the antiplatelet effect of aspirin. Moreover, aggregometric point of care testing was identified to be a suitable tool for the identification of patients with primary aspirin resistance (n = 3).</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>26993144</pmid><doi>10.1177/1708538116638961</doi><tpages>9</tpages></addata></record> |
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| source | MEDLINE; SAGE Complete A-Z List |
| subjects | Aged Aged, 80 and over Anticoagulants - administration & dosage Anticoagulants - adverse effects Aspirin - adverse effects Aspirin - therapeutic use Blood Coagulation - drug effects Blood Coagulation Tests Carotid Artery Diseases - blood Carotid Artery Diseases - diagnostic imaging Carotid Artery Diseases - surgery Drug Resistance Endarterectomy, Carotid - adverse effects Female Heparin - administration & dosage Heparin - adverse effects Humans Male Middle Aged Platelet Aggregation - drug effects Platelet Aggregation Inhibitors - adverse effects Platelet Aggregation Inhibitors - therapeutic use Platelet Function Tests Point-of-Care Testing Predictive Value of Tests Prospective Studies Treatment Outcome |
| title | The role of unfractionated heparin for the antiaggregatory effect of aspirin in patients undergoing carotid endarterectomy: Results of an observational clinical study |
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