Faculty Opinions recommendation of Tranexamic acid partially improves platelet function in patients treated with dual antiplatelet therapy.

2011 ◽  
Author(s):  
John Augoustides ◽  
Hynek Riha
Keyword(s):  
Tranexamic Acid ◽  
Antiplatelet Therapy ◽  
Platelet Function ◽  
Dual Antiplatelet Therapy

Tranexamic acid partially improves platelet function in patients treated with dual antiplatelet therapy

2011 ◽  
Vol 28 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Christian F Weber ◽  
Klaus Görlinger ◽  
Christian Byhahn ◽  
Anton Moritz ◽  
Alexander A Hanke ◽  
...  
Keyword(s):  
Tranexamic Acid ◽  
Antiplatelet Therapy ◽  
Platelet Function ◽  
Dual Antiplatelet Therapy

Supplemental Fibrinogen Restores Platelet Inhibitor-Induced Reduction in Thrombus Formation without Altering Platelet Function: An In Vitro Study

2020 ◽  
Vol 120 (11) ◽  
pp. 1548-1556
Author(s):  
Thomas Bärnthaler ◽  
Elisabeth Mahla ◽  
Gabor G. Toth ◽  
Rufina Schuligoi ◽  
Florian Prüller ◽  
...  
Keyword(s):  
Antiplatelet Therapy ◽  
Platelet Activation ◽  
Platelet Function ◽  
Dual Antiplatelet Therapy ◽  
Thrombus Formation ◽  
In Vitro Study ◽  
Coronary Intervention ◽  
Calcium Flux ◽  
Major Surgery

Abstract Background For patients treated with dual antiplatelet therapy, standardized drug-specific 3-to-7 day cessation is recommended prior to major surgery to reach sufficient platelet function recovery. Here we investigated the hypothesis that supplemental fibrinogen might mitigate the inhibitory effects of antiplatelet therapy. Methods and Results To this end blood from healthy donors was treated in vitro with platelet inhibitors, and in vitro thrombus formation and platelet activation were assessed. Ticagrelor, acetylsalicylic acid, the combination of both, and tirofiban all markedly attenuated the formation of adherent thrombi, when whole blood was perfused through collagen-coated microchannels at physiological shear rates. Addition of fibrinogen restored in vitro thrombus formation in the presence of antiplatelet drugs and heparin. However, platelet activation, as investigated in assays of P-selectin expression and calcium flux, was not altered by fibrinogen supplementation. Most importantly, fibrinogen was able to restore in vitro thrombogenesis in patients on maintenance dual antiplatelet therapy after percutaneous coronary intervention. Conclusion Thus, our in vitro data support the notion that supplementation of fibrinogen influences the perioperative hemostasis in patients undergoing surgery during antiplatelet therapy by promoting thrombogenesis without significantly interfering with platelet activation.

scholarly journals Thromboelastography for monitoring platelet function in unruptured intracranial aneurysm patients undergoing stent placement

2015 ◽  
Vol 21 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Hongchao Yang ◽  
Youxiang Li ◽  
Yuhua Jiang ◽  
Xianli Lv
Keyword(s):  
Intracranial Aneurysm ◽  
Antiplatelet Therapy ◽  
Platelet Function ◽  
Dual Antiplatelet Therapy ◽  
Platelet Inhibition ◽  
Acute Ischemia ◽  
Unruptured Intracranial Aneurysm ◽  
Anterior Circulation ◽  
Permanent Disability ◽  
Significant Difference

This study evaluated patients’ preoperative platelet function and the relation between acute embolic or hemorrhagic complications in unruptured intracranial aneurysm patients undergoing stent treatment. From September 2013 to December 2013 we prospectively collected clinical data in all unruptured intracranial aneurysm patients undergoing stent-assisted coiling. All patients received a dual antiplatelet therapy (aspirin and clopidogrel) protocol. Diffusion-weighted 3-T MRI was performed for cerebral aneurysm patients within 24 hours after treatment. Platelet function was tested by thromboelastography. Forty-six patients with 50 intracranial aneurysms treated by stent-assisted coiling were included. Fifty-three stents were deployed in 46 procedures, including 39 Enterprise stents and 14 Solitaire stents. Acute ischemia was detected in the territory of the stented vessel in 25 of 46 patients (54.3%), but did not cause permanent disability. There was a significant difference between groups with and without thromboembolism in terms of percentage platelet inhibition and ADP-induced clot strength (MAADP) for clopidogrel, but no significant difference with aspirin. MAADP had a predictive value yielding an area under the ROC curve of 0.67 (95% CI: 0.57–0.81, P < 0.05). Anterior circulation aneurysms were also associated with ischemic events (P = 0.034). Silent acute embolism may be frequent in unruptured intracranial aneurysm treated with stent-assisted coiling even when dual antiplatelet therapy is given. The antiplatelet inhibition parameter (MAADP) was a predictor for acute thromboembolism in unruptured intracranial aneurysm patients treated by stent-assisted coiling.

scholarly journals Analysis of Platelet Function from Thromboelastography Examination in Patients with Single and Multiple Antiplatelet Therapy after Percutaneous Coronary Intervention in Dr. Saiful Anwar Malang

2020 ◽  
Vol 7 (1) ◽  
pp. 19-28
Author(s):  
Sasmojo Widito ◽  
Dadang Hendrawan ◽  
Dedy Irawan
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Antiplatelet Therapy ◽  
Platelet Function ◽  
Dual Antiplatelet Therapy ◽  
Coronary Intervention ◽  
Primary Therapy ◽  
Research Subjects ◽  
Platelet Function Test ◽  
Percutaneous Coronary ◽  
Significant Difference

Each year, approximately 3 million people with coronary heart disease worldwide undergo percutaneous coronary intervention (PCI). Dual antiplatelet therapy (DAPT) with aspirin and P2Y12 inhibitors became the primary therapy for 6-12 months after PCI. DAPT can be continued > 12 months at a high risk of thrombosis. About 9-10% of patients with dual antiplatelet therapy still experience ischemia. The platelet function examination by thromboelastography (TEG). This research is an analytic observational study using a cross-sectional method. This study was conducted in Saiful Anwar General Hospital. Patients were divided into two groups: (1) on-single antiplatelet therapy; (2) on-dual antiplatelet therapy. The outcome measured result of the platelet function test was divided into standard, low platelet function, and platelet hypercoagulability. An analysis of the differences between single or multiple antiplatelet administration and the platelet function results was performed. There were 52 research subjects, each group of single and multiple antiplatelet therapies as many as 26 people, most of the subjects were male (82.6%) with a mean age of 57. The results of this study showed that there was no significant difference in the results of platelet function examinations between single and multiple antiplatelet therapies after 12 months of dual antiplatelet therapy.

Abstract 1032: High Clopidogrel Maintenance Dosing in Patients with Inadequate Platelet Inhibition: Functional Insights on Thienopyridine Usage According to Updated ACC/AHA/SCAI 2005 Guidelines for Percutaneous Coronary Interventions

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Dominick J Angiolillo ◽  
Marco A Costa ◽  
Steven B Shoemaker ◽  
Bhaloo Desai ◽  
Yuan Hang ◽  
...  
Keyword(s):  
Steady State ◽  
High Risk ◽  
Antiplatelet Therapy ◽  
Platelet Function ◽  
Maintenance Dose ◽  
Dual Antiplatelet Therapy ◽  
Platelet Inhibition ◽  
Percutaneous Coronary Interventions ◽  
Percutaneous Coronary ◽  
Risk Patients

Background: Clopidogrel under-dosing is a cause of inadequate platelet inhibition. Inadequate clopidogrel-induced antiplatelet effects have been associated with an increased risk of stent thrombosis. Updated guidelines for percutaneous coronary interventions (PCI) recommend to increase the dose of clopidogrel to 150mg in high risk patients if <50% platelet inhibition is demonstrated. However, to date there are no studies which have evaluated the functional impact of this recommendation. The aim of this study was determine the functional impact of a 150mg maintenance dose of clopidogrel in patients with 50% platelet inhibition while in their steady state phase of dual antiplatelet therapy. Methods: Platelet inhibition was screened by means of the VerifyNow P2Y 12 assay in patients in a steady state phase of dual antiplatelet therapy. Patients with <50% platelet inhibition were treated with 150mg of clopidogrel for one-month. Adenosine diphosphate-induced aggregation using light transmittance aggregometry and P2Y 12 reactivity ratio determined by vasodilator-stimulated phosphoprotein-phosphorylation analysis were also performed. Results: A total of 32 patients were screened to identify 20 with <50% platelet inhibition. Platelet inhibition increased from 28.3±12% to 43.2±18% in patients treated with 150mg of clopidogrel (p=0.004; primary endpoint). All other functional measures also showed that a high maintenance dose of clopidogrel reduces platelet function (Table ) . The degree of platelet inhibition achieved following one-month treatment with high dose clopidogrel broadly varied and only eight (40%) patients yielded a degree of platelet inhibition ≥50%. Conclusions: The use of a 150mg maintenance dose of clopidogrel in high risk patients with <50% platelet inhibition increases platelet inhibition. However, the antiplatelet effects achieved are non-uniform and a considerable number of patients persist with elevated platelet function. Platelet function analysis pre and post high clopidogrel maintenance dose therapy

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