Evaluation of multiple electrode aggregometry for the perioperative assessment of aspirin therapy in cardiac surgery

Objective of the study: The aim of this study was to investigate the feasibility of the Multiple Electrode Aggregometry (MEA) device for reliable assessment of arachidonic acid-induced platelet function after preoperative cessation and postoperative restarting of aspirin therapy.Methods: 102 consecutive patients undergoing coronary artery bypass grafting (CABG) were enrolled in this prospective study. After preoperative cessation for at least five days, 100 mg aspirin was restarted on the first day after surgery. Platelet function was assessed by performing Light Transmission Aggregometry (LTA) and MEA on the day before surgery (T0), four hours (T1) and five days after restarting aspirin therapy (T2). Platelet aggregation was induced using 0.5 mg/ml arachidonic acid for the LTA (ASAtest) analysis and 0.5 mM arachidonic acid (ASPItest) and 32 mM thrombin receptor activating peptide (TRAPtest) for the MEA analysis, respectively.Results: Arachidonic acid-induced platelet aggregation was found impaired at T1 and T2 in both MEA and LTA, while platelet aggregation in TRAPtest (MEA) did not change significantly as compared to baseline. Platelet aggregation in ASPItest (MEA) was significantly correlated with the ASAtest (LTA) at pre- and postoperative measuring points. Conclusions: MEA enables the assessment of potential residual effects of preoperatively ceased aspirin therapy. After postoperative restarting of daily aspirin therapy, MEA reliably detects aspirin non-responsiveness in a rapid and practicable manner. Therefore, MEA may be helpful to control and potentially adjust the aspirin dosage in patients following CABG surgery.