Multiple Electrode Whole-Blood Aggregometry and Bleeding in Cardiac Surgery Patients Receiving Thienopyridines

Bleeding risk assessment using multiple electrode aggregometry in patients following coronary artery bypass surgery

“…Ranucci et al [18] have found on an independent association between the MEA ADP test and postoperative bleeding and procoagulant blood products transfusion. The authors did not report on the proportion of patients that were also receiving ASA in addition to thienopyridines nor were ASPI test values obtained [18].…”

“…Valuable data concerning MEA guided hemostatic management of patients receiving thienopyridines has been previously published [18]. Ranucci et al [18] have found on an independent association between the MEA ADP test and postoperative bleeding and procoagulant blood products transfusion.…”

“…Finally, the authors have performed thromboelastography in a select population of patients, and desmopresin was administered according to MEA ADP test in the presence of micro vascular bleeding [18]. This can markedly influence the primary outcome, as much as secondary outcome, and thus create a bias since not all patients had the same hemostatic management [19].…”

Antiplatelet therapy before cardiac surgery

“…Preoperative strong antiplatelet-drug-induced inhibition is an important contributory factor that is correlated with increased postoperative bleeding and platelet transfusion requirement [2,[25][26][27][28][29][30].…”

How I use laboratory monitoring of antiplatelet therapy

“…on May 10, 2018. by guest www.bloodjournal.org From obligated to wait the requisite number of days listed in the drug labeling or guidelines. [80][81][82] CYP2C19*2 single nucleotide polymorphism. Clopidogrel is metabolized through the cytochrome P-450 family of enzymes to generate the active metabolite required for inhibition of the platelet ADP receptor P2Y 12 .…”