On-treatment platelet reactivity before coronary artery bypass surgery is associated with in-hospital major bleeding




Background


Patients often undergo coronary-artery bypass graft (CABG) within 5–7 days of thienopyridine therapy. Evidence supporting the use of on-treatment platelet reactivity testing before CABG is very limited. We hypothesized that low on-treatment platelet reactivity before CABG would be associated with higher in-hospital major bleeding (IHMB).




Methods


On-treatment platelet reactivity was prospectively measured with Verify Now (VN) P2Y12 assay, vasodilator stimulated phosphoprotein phosphorylation (VASP), and light transmittance aggregometry (LTA) with 5 and 20 μM of ADP. The population consisted of 51 patients undergoing CABG within 5 days of thienopyridine discontinuation between August 2010 and May 2011. The primary end point was IHMB, defined as bleeding intracranially or that associated with hemodynamic compromise, a hemoglobin (Hb) drop of >5g/dl, or a hematocrit drop of >15%. The relation between platelet reactivity value and IHMB was assessed with Wilcoxon rank-sum test; its relation with Hb drop was evaluated with Spearman correlation.

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Nov 16, 2017 | Posted by in CARDIOLOGY | Comments Off on On-treatment platelet reactivity before coronary artery bypass surgery is associated with in-hospital major bleeding

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