아스피린의 중단 시기와 PFA-100을 이용한 혈소판 부착 및 응집능 검사 (Platelet function assay to determine the optimal preoperative cessation period of aspirin)

서지정보

· 발행기관 : 대한마취통증의학회
· 수록지 정보 : Anesthesia and Pain Medicine / 9권 / 1호 / 31 ~ 35페이지
· 저자명 : 김영성, 이일옥, 박혜윤, 박지혜, 임병건, 김희주

초록

Background: This study was conducted to assess preoperativeresidual antiplatelet-induced platelet dysfunction using a plateletfunction assay to determine the optimal cessation period of aspirinduring the preoperative period.
Methods: Patients older than 20 years, who were scheduled forelective surgery under general anesthesia, were enrolled prospectively.
The last ingestion of the aspirin had occurred within theprevious 10 days before surgery (aspirin 100 mg per day). Nohistory of antiplatelet intake was documented in the control group.
Platelet function was assessed using a platelet function analyzer-100 (PFA-100). Receiver operating characteristic (ROC) curveswere plotted to determine the ability of aspirin cessation time in orderto predict platelet function as assessed by the PFA. Patients wereassigned to groups according to the period of aspirin discontinuation.
Results: Two hundred patients were enrolled in this study (100control group and 100 aspirin group). The mean PFA value of thecontrol group was significantly lower than that of the treated groups.
The areas under the ROC curve (0.65, P = 0.03) of aspirin cessationperiod to discriminate PFA prolongation were significant. Therewere significant decreases in PFA values when aspirin medicationwas discontinued for 7 days, but not when the intake was discontinuedfor 5 days.
Conclusions: Platelet function recovered if aspirin intake wasdiscontinued ＞ 7 days prior to surgery; therefore, in these patients,a preoperative platelet function test is not essential. However, theresidual antiplatelet effect of aspirin should be assessed using thePFA in patients who discontinue aspirin less than 7 days prior tosurgery.

영어초록

Background: This study was conducted to assess preoperativeresidual antiplatelet-induced platelet dysfunction using a plateletfunction assay to determine the optimal cessation period of aspirinduring the preoperative period.
Methods: Patients older than 20 years, who were scheduled forelective surgery under general anesthesia, were enrolled prospectively.
The last ingestion of the aspirin had occurred within theprevious 10 days before surgery (aspirin 100 mg per day). Nohistory of antiplatelet intake was documented in the control group.
Platelet function was assessed using a platelet function analyzer-100 (PFA-100). Receiver operating characteristic (ROC) curveswere plotted to determine the ability of aspirin cessation time in orderto predict platelet function as assessed by the PFA. Patients wereassigned to groups according to the period of aspirin discontinuation.
Results: Two hundred patients were enrolled in this study (100control group and 100 aspirin group). The mean PFA value of thecontrol group was significantly lower than that of the treated groups.
The areas under the ROC curve (0.65, P = 0.03) of aspirin cessationperiod to discriminate PFA prolongation were significant. Therewere significant decreases in PFA values when aspirin medicationwas discontinued for 7 days, but not when the intake was discontinuedfor 5 days.
Conclusions: Platelet function recovered if aspirin intake wasdiscontinued ＞ 7 days prior to surgery; therefore, in these patients,a preoperative platelet function test is not essential. However, theresidual antiplatelet effect of aspirin should be assessed using thePFA in patients who discontinue aspirin less than 7 days prior tosurgery.

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