Aspirin resistance in adult patients after Fontan surgery

2015
journal article
article
cris.lastimport.wos2024-04-09T22:42:47Z
dc.abstract.enBackground: Thrombotic complications are common in adult patients who have had a Fontan operation early in life for treatment of congenital heart disease. Objective: To characterize platelet function and responsiveness to aspirin in relation to thrombogenesis, systemic inflammation, and markers of endothelial function in adults with Fontan circulation (FC). Methods: Thirty-four FC patients (age 18–40 years; 62% taking aspirin chronically and 38% not taking aspirin) and 32 age- and sex-matched healthy controls were studied. Platelet function was evaluated by measurement of basal concentrations of thromboxane B2 (TXB2) and sCD40L and ex-vivo generation of TXB2 and sCD40L. Plasma concentrations of thrombin–antithrombin, endothelin-1, vWF, IL-6, IL-8, MCP-1, MIP-1β, TNFα, sVCAM-1, and syndecan-1 also were measured. Results: Platelet numbers were significantly lower in FC patients than in controls, but the patients had significantly higher platelet activity, as evidenced by higher TXB2 and sCD40L concentrations and higher ex vivo generation of TXB2. Chronic aspirin treatment had no effect on plasma concentrations of TXB2 and sCD40L in FC, but in 52% of aspirin-treated FC subjects, TXB2 concentrations remained elevated at 60 min of TXB2 generation, indicating aspirin resistance. In addition, FC patients had increased levels of thrombin–antithrombin, endothelin-1, vWF, IL-8, MCP-1, MIP-1β, TNFα, sVCAM-1, and syndecan-1 but not of IL-6. Conclusion: Adults with FC had lower platelet numbers but increased platelet activity, increased thrombogenesis, systemic inflammation, and endothelial dysfunction. A significant proportion of aspirin-treated FC adults had aspirin resistance, which may be at least in part responsible for their increased incidence of thrombotic complications.pl
dc.affiliationWydział Lekarski : Instytut Kardiologiipl
dc.affiliationPion Rektora : Jagiellońskie Centrum Rozwoju Lekówpl
dc.affiliationWydział Lekarski : Zakład Farmakologii Doświadczalnejpl
dc.cm.id69309
dc.contributor.authorTomkiewicz-Pająk, Lidia - 255811 pl
dc.contributor.authorWójcik, Tomasz - 200897 pl
dc.contributor.authorChłopicki, Stefan - 128995 pl
dc.contributor.authorOlszowska, Maria - 133035 pl
dc.contributor.authorPająk, Jacekpl
dc.contributor.authorPodolec, Jakub - 133184 pl
dc.contributor.authorSitek, Barbara - 200898 pl
dc.contributor.authorMusiałek, Piotr - 173944 pl
dc.contributor.authorRubiś, Paweł - 320209 pl
dc.contributor.authorKomar, Monikapl
dc.contributor.authorPodolec, Piotr - 133185 pl
dc.date.accessioned2015-02-16T15:46:52Z
dc.date.available2015-02-16T15:46:52Z
dc.date.issued2015pl
dc.description.physical19-26pl
dc.description.points40pl
dc.description.volume181pl
dc.identifier.doi10.1016/j.ijcard.2014.11.219pl
dc.identifier.eissn1874-1754pl
dc.identifier.issn0167-5273pl
dc.identifier.urihttp://ruj.uj.edu.pl/xmlui/handle/item/3117
dc.languageengpl
dc.language.containerengpl
dc.rightsDodaję tylko opis bibliograficzny*
dc.rights.uri*
dc.subject.enFontan surgerypl
dc.subject.enPlatelet reactivitypl
dc.subject.enThromboxane B2 generation testpl
dc.subject.eninflammationpl
dc.subject.enendothelial functionpl
dc.subject.enaspirin resistancepl
dc.subtypeArticlepl
dc.titleAspirin resistance in adult patients after Fontan surgerypl
dc.title.journalInternational Journal of Cardiologypl
dc.typeJournalArticlepl
dspace.entity.typePublication
cris.lastimport.wos
2024-04-09T22:42:47Z
dc.abstract.enpl
Background: Thrombotic complications are common in adult patients who have had a Fontan operation early in life for treatment of congenital heart disease. Objective: To characterize platelet function and responsiveness to aspirin in relation to thrombogenesis, systemic inflammation, and markers of endothelial function in adults with Fontan circulation (FC). Methods: Thirty-four FC patients (age 18–40 years; 62% taking aspirin chronically and 38% not taking aspirin) and 32 age- and sex-matched healthy controls were studied. Platelet function was evaluated by measurement of basal concentrations of thromboxane B2 (TXB2) and sCD40L and ex-vivo generation of TXB2 and sCD40L. Plasma concentrations of thrombin–antithrombin, endothelin-1, vWF, IL-6, IL-8, MCP-1, MIP-1β, TNFα, sVCAM-1, and syndecan-1 also were measured. Results: Platelet numbers were significantly lower in FC patients than in controls, but the patients had significantly higher platelet activity, as evidenced by higher TXB2 and sCD40L concentrations and higher ex vivo generation of TXB2. Chronic aspirin treatment had no effect on plasma concentrations of TXB2 and sCD40L in FC, but in 52% of aspirin-treated FC subjects, TXB2 concentrations remained elevated at 60 min of TXB2 generation, indicating aspirin resistance. In addition, FC patients had increased levels of thrombin–antithrombin, endothelin-1, vWF, IL-8, MCP-1, MIP-1β, TNFα, sVCAM-1, and syndecan-1 but not of IL-6. Conclusion: Adults with FC had lower platelet numbers but increased platelet activity, increased thrombogenesis, systemic inflammation, and endothelial dysfunction. A significant proportion of aspirin-treated FC adults had aspirin resistance, which may be at least in part responsible for their increased incidence of thrombotic complications.
dc.affiliationpl
Wydział Lekarski : Instytut Kardiologii
dc.affiliationpl
Pion Rektora : Jagiellońskie Centrum Rozwoju Leków
dc.affiliationpl
Wydział Lekarski : Zakład Farmakologii Doświadczalnej
dc.cm.id
69309
dc.contributor.authorpl
Tomkiewicz-Pająk, Lidia - 255811
dc.contributor.authorpl
Wójcik, Tomasz - 200897
dc.contributor.authorpl
Chłopicki, Stefan - 128995
dc.contributor.authorpl
Olszowska, Maria - 133035
dc.contributor.authorpl
Pająk, Jacek
dc.contributor.authorpl
Podolec, Jakub - 133184
dc.contributor.authorpl
Sitek, Barbara - 200898
dc.contributor.authorpl
Musiałek, Piotr - 173944
dc.contributor.authorpl
Rubiś, Paweł - 320209
dc.contributor.authorpl
Komar, Monika
dc.contributor.authorpl
Podolec, Piotr - 133185
dc.date.accessioned
2015-02-16T15:46:52Z
dc.date.available
2015-02-16T15:46:52Z
dc.date.issuedpl
2015
dc.description.physicalpl
19-26
dc.description.pointspl
40
dc.description.volumepl
181
dc.identifier.doipl
10.1016/j.ijcard.2014.11.219
dc.identifier.eissnpl
1874-1754
dc.identifier.issnpl
0167-5273
dc.identifier.uri
http://ruj.uj.edu.pl/xmlui/handle/item/3117
dc.languagepl
eng
dc.language.containerpl
eng
dc.rights*
Dodaję tylko opis bibliograficzny
dc.rights.uri*
dc.subject.enpl
Fontan surgery
dc.subject.enpl
Platelet reactivity
dc.subject.enpl
Thromboxane B2 generation test
dc.subject.enpl
inflammation
dc.subject.enpl
endothelial function
dc.subject.enpl
aspirin resistance
dc.subtypepl
Article
dc.titlepl
Aspirin resistance in adult patients after Fontan surgery
dc.title.journalpl
International Journal of Cardiology
dc.typepl
JournalArticle
dspace.entity.type
Publication

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