Association of Adenosine Diphosphate–Induced Platelet Maximum Amplitude With Postoperative Bleeding and Blood Transfusions in Patients Undergoing Coronary Artery Bypass Grafting

Tian, Lijuan; Gao, Xurong; Yang, Jing; Yao, Yun-Tai; Ji, Hongwen

doi:10.1053/j.jvca.2020.07.009

Cited by 5 publications

(3 citation statements)

References 26 publications

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“…Platelet Mapping was originally used as an assay to evaluate platelet inhibition and aggregation by antiplatelet drugs, such as ADP receptor antagonists and aspirin. In the field of cardiovascular surgery, preoperative Platelet Mapping measurements have been shown to be useful in predicting postoperative bleeding and transfusion strategies [ 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

TEG6s Platelet Mapping assay for the estimation of plasma fibrinogen concentration during cardiovascular surgery: a single-center prospective observational study

et al. 2021

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Purpose The Activator F (ActF) test on the TEG6s Platelet Mapping assay system is a means of quantifying blood viscoelasticity caused by fibrin network formation, triggered by reptilase and factor XIII, while platelets are inhibited. This unique methodology enables the measurement of blood viscoelasticity, even in highly heparinized blood. Here, we investigated whether fibrinogen concentration could be estimated using the ActF test in blood samples obtained during cardiopulmonary bypass (CPB) and after CPB in patients undergoing cardiovascular surgery. Methods We performed a single-center prospective observational study at a university hospital. Forty patients aged ≥ 18 years who underwent elective cardiovascular surgery with CPB were enrolled. Blood samples were drawn after the induction of anesthesia, after declamping of the aorta during CPB, and after the reversal of heparinization using protamine (after CPB). Coagulation profiles were evaluated using the Platelet Mapping assay and standard laboratory tests. Results There were strong correlations between the maximal amplitude of clot strength (MA) in the ActF test and fibrinogen concentration in samples drawn during CPB (R = 0.84, 95% confidence interval [CI] 0.72–0.91; P < 0.001) and after CPB (R = 0.83, 95% CI 0.70–0.91; P < 0.001). The areas under the receiver-operating characteristic curve for the ActF MA for fibrinogen concentrations < 150 mg/dL were 0.86 (95% CI 0.73–1.0) during CPB and 0.98 (95% CI 0.94–1.0) after CPB. Conclusion TEG6s Platelet Mapping ActF MA values strongly correlated with plasma fibrinogen concentration in highly heparinized blood during CPB and yielded highly accurate measurements of low fibrinogen concentrations.

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Section: Discussionmentioning

confidence: 99%

TEG6s Platelet Mapping assay for the estimation of plasma fibrinogen concentration during cardiovascular surgery: a single-center prospective observational study

et al. 2021

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“…VET has also become the most widely available means of assessing the fibrinolytic system, improving recognition and treatment of its disorders. VET also has some utility in the assessment of platelet function to predict patient bleeding, 104 though it underperforms compared to other platelet testing methods in predicting antiplatelet agent use 32 . VET has also recently become a method of interest in the management of patients with hemophilia 105 and other hematologic or autoimmune conditions 14 …”

Section: Discussionmentioning

confidence: 99%

Viscoelastic testing: Critical appraisal of new methodologies and current literature

Wool

Carll

2023

Int J Lab Hematology

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United States Food and Drug Administration (FDA)‐approved viscoelastic testing (VET) methodologies have significantly changed in the last 10 years, with the availability of cartridge‐based VET. Some of these cartridge‐based methodologies use harmonic resonance‐based clot detection. While VET has always allowed for the evaluation of real‐time clot formation, cartridge‐based VET provides increased ease of use as well as greater portability and robustness of results in out‐of‐laboratory environments. Here we review the use of VET in a variety of clinical contexts, including cardiac surgery, trauma, liver transplant, obstetrics, and hypercoagulable states such as COVID‐19. As of now, high quality randomized trial evidence for new generation VET (TEG 6s, HemoSonics Quantra, ROTEM sigma) is limited. Nevertheless, the use of VET‐guided transfusion algorithms appears to result in reduced blood usage without worsening of patient outcomes. Future work comparing the new generation VET instruments and continuing to validate clinically important cut‐offs will help move the field of point‐of‐care coagulation monitoring forward and increase the quality of transfusion management in bleeding patients.

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“…Hypercoagulability plays a highly considerable role in the progression of malignancies 7,8 The maximum amplitude (MA), one of thromboelastography (TEG) parameters, by measuring the clot strength in whole blood with a viscoelastic test, can quantify hypercoagulation status and platelet activity 9 Maximum amplitude-identified hypercoagulability has been found to be an independent prognostic factor for lung adenocarcinoma cancer and predictive of TNM Stage [10][11][12] The Mean platelet volume (MPV), a conventional parameter in blood that can be used to determine platelet size and activity. Increasing evidence founded that platelet function and activation may be evaluated by MPV, as a readily blood marker 13,14 Mean platelet volume is related to not only a variety of hypercoagulation status but also malignant lung cancer 15,16 However, whether MA and MPV can be an available marker to diagnose malignant GGNs is not clear yet.…”

Section: Introductionmentioning

confidence: 99%

Maximum amplitude and mean platelet volume in the blood as biomarkers to detect lung adenocarcinoma cancer featured with ground-glass nodules

et al. 2023

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Objectives The development and progression of malignancies are closely linked to hypercoagulability. As an early type of lung adenocarcinoma, ground glass nodules (GGNs) have been detected increasingly. Blood Maximum amplitude (MA) and mean platelet volume (MPV) are related to various conditions of hypercoagulability. Therefore, the role of MA and MPV in diagnosing lung adenocarcinoma cancer featured with GGNs was investigated in this case-control study. Methods The analyzed data of this study is derived from GGNs patients and healthy individuals in West China (Airport) Hospital Sichuan University. The differences between GGNs patients and healthy individuals were determined by one-way ANOVA, logistic regression or chi-squared test. The accuracy of diagnostic was performed by receiver operating characteristic curve (ROC). The relative mRNA expressions were studied by RT-qPCR. Results 470 patients diagnosed with GGNs which benign lesions (BN group) are inflammatory and malignant lesions (LC group) are adenocarcinoma in stage IA, and 235 healthy subjects (HC group) were enrolled in this study. Levels of MA and MPV were increased in LC group compared with BN and HC group ( p < 0.001, p < 0.001). When we combined MA and MPV, MA and MPV presented a sensitivity (SEN) of 0.809 and a specificity (SPE) of 0.774. And the area under the curve (AUC) increased to 0.871 (0.837–0.900) when confidence interval was 95%. Conclusion This study demonstrates that there have been systemic changes in coagulation disorders in the pathogenesis of GGNs. The diagnostic ability to different lung adenocarcinoma cancer featured with GGNs from benign or healthy controls can be improved by the combination of MA and MPV. Maximum amplitude and MPV may be used as biomarkers to detect lung adenocarcinoma cancer featured with GGNs.

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Association of Adenosine Diphosphate–Induced Platelet Maximum Amplitude With Postoperative Bleeding and Blood Transfusions in Patients Undergoing Coronary Artery Bypass Grafting

Cited by 5 publications

References 26 publications

TEG6s Platelet Mapping assay for the estimation of plasma fibrinogen concentration during cardiovascular surgery: a single-center prospective observational study

TEG6s Platelet Mapping assay for the estimation of plasma fibrinogen concentration during cardiovascular surgery: a single-center prospective observational study

Viscoelastic testing: Critical appraisal of new methodologies and current literature

Maximum amplitude and mean platelet volume in the blood as biomarkers to detect lung adenocarcinoma cancer featured with ground-glass nodules

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