Does thromboelastography predict bleeding in patients treated with clopidogrel or ticagrelor in off-pump coronary artery bypass grafting?

Association between ticagrelor plasma concentration and bleeding events in Chinese patients with acute coronary syndrome

“…In contrast, in patients with ACS or undergoing off‐pump coronary artery bypass grafting, the percentage of ADP‐induced platelet aggregation predicted neither universal definition of perioperative bleeding‐defined nor BARC‐defined major bleeding, 28,29 which was in line with our result. Due to the complexity of bleeding in cardiovascular diseases and diversified antithrombotic therapies, ADP‐induced platelet aggregation test may not be sufficient to predict bleeding events 29 …”

“…In addition, several previous reports had identified the relationship between the pharmacodynamics of ticagrelor and bleeding events 26–29 . In patients with acute myocardial infarction complicated by cardiogenic shock, Scherer et al .…”

“…In addition, several previous reports had identified the relationship between the pharmacodynamics of ticagrelor and bleeding events. [26][27][28][29] In patients with acute myocardial infarction complicated by cardiogenic shock, Scherer et al found on-treatment ADP-induced platelet aggregation was an independent risk factor for severe BARC type ≥3 bleedings. 26 In contrast, in patients with ACS or undergoing off-pump coronary artery bypass grafting, the percentage of ADP-induced platelet aggregation predicted neither universal definition of perioperative bleeding-defined nor BARC-defined major bleeding, 28,29 which was in line with our result.…”

“…[26][27][28][29] In patients with acute myocardial infarction complicated by cardiogenic shock, Scherer et al found on-treatment ADP-induced platelet aggregation was an independent risk factor for severe BARC type ≥3 bleedings. 26 In contrast, in patients with ACS or undergoing off-pump coronary artery bypass grafting, the percentage of ADP-induced platelet aggregation predicted neither universal definition of perioperative bleeding-defined nor BARC-defined major bleeding, 28,29 which was in line with our result. Due to the complexity of bleeding in cardiovascular diseases and diversified antithrombotic therapies, ADP-induced platelet aggregation test may not be sufficient to predict bleeding events.…”

“…Due to the complexity of bleeding in cardiovascular diseases and diversified antithrombotic therapies, ADP-induced platelet aggregation test may not be sufficient to predict bleeding events. 29 Race, sex, older age, renal function and ACS types have been reported as independent factors associated with bleeding events in ticagrelor therapy. [30][31][32][33] However, apart from ticagrelor and metabolite concentrations, this study only found a higher risk of bleeding in female patients than in men (Table 1).…”