Platelet Function Testing and Tailored Antiplatelet Therapy

Janssen, Paul W.A.; Berg, Jürrien M. ten

doi:10.1007/s12265-013-9458-z

Cited by 37 publications

(27 citation statements)

References 83 publications

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“…2 As there is evidence of a therapeutic window for PLT inhibition, PLT function tests could be helpful for tailoring antiplatelet therapy based on the patient's thrombotic and bleeding risk. 19,23 Future studies should focus on the long-term effect of dual antiplatelet therapy on PLT activation after EVAR.…”

Section: Discussionmentioning

confidence: 99%

Platelet activation after endovascular repair of abdominal aortic aneurysm

et al. 2015

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Aim: To investigate the effect of endovascular aneurysm repair (EVAR) on platelet (PLT) function and reveal possible associated factors. Methods: Fifty consecutive patients were included. PLT count and activation (CD62P-CD36), white blood cell (WBC) count, and high sensitivity C-reactive protein (hs-CRP) were measured preoperatively, at the first and third postoperative day. Results: EVAR elicited a significant reduction in PLT count from baseline to first day after EVAR (p < 0.001), while no significant difference was noted between the first and third day. Furthermore, CD62P expression was markedly elevated at the first day after EVAR (median % positive PLTs from 13.7 at baseline to 22.1, p ¼ 0.05), but returned to baseline levels by the third day. Maximum abdominal aortic aneurysm diameter was the only factor that significantly affected the CD62P values (p ¼ 0.005). Postoperative CD36 values were significantly correlated with total aneurysm volume (p ¼ 0.05) and were higher in endografts made from polyester (p ¼ 0.01). There were no correlation between PLT activation and hs-CRP, WBC, maximum temperature, and 30-day morbidity. Conclusion: EVAR has elucidated a significant reduction in PLT count and increase in PLT activation at the immediate postoperative period. The type of the endograft material and the aneurysm maximum diameter and volume appear to play an important role in PLT activation.

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Section: Discussionmentioning

confidence: 99%

Platelet activation after endovascular repair of abdominal aortic aneurysm

et al. 2015

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“…Platelet function testing remains controversial despite a substantial body of cardiovascular literature supporting it (reviewed by Aradi et al 15 and Janssen and ten Berg16), but it has been pointed out that the data for the use of platelet function testing are particularly weak for neurovascular procedures and that the pharmacology of P2Y12 inhibition has evolved beyond clopidogrel so that concerns about pharmacological non-response may no longer be relevant 17. However, clopidogrel is now generic and thus far less expensive than newer P2Y12 inhibitors and will still be widely used.…”

Section: Discussionmentioning

confidence: 99%

Use of thromboelastography to tailor dual-antiplatelet therapy in patients undergoing treatment of intracranial aneurysms with the Pipeline embolization device

McTaggart

Choudhri

Marcellus

et al. 2014

J NeuroIntervent Surg

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Platelet function testing with TEG altered our DAT induction strategy in a significant number of cases. No hemorrhagic or disabling thromboembolic complications were seen in this series. Future studies should compare methods of platelet function testing and, possibly, no platelet function testing in neurovascular patients undergoing flow diversion and/or stent-assisted treatment of intracranial aneurysms.

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“…The use of aspirin and a P2Y12 receptor inhibitor, the so-called dual antiplatelet therapy (DAPT), has dramatically reduced atherothrombotic events in patients with acute coronary syndrome and those who undergo percutaneous coronary intervention (PCI). [3031] A minimum of 6 weeks DAPT after bare metal stent insertion and at least 12 months after drug-eluting stent placement is recommended to avoid thrombotic complications. [32]…”

Section: Thrombin Inhibitorsmentioning

confidence: 99%

Perioperative considerations and management of patients receiving anticoagulants

et al. 2017

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Anticoagulants remain the primary strategy for the prevention and treatment of thrombosis. Unfractionated heparin, low molecular weight heparin (LMWH), fondaparinux, and warfarin have been studied and employed extensively with direct thrombin inhibitors typically reserved for patients with complications or those requiring interventions. Novel oral anticoagulants have emerged from clinical development and are expected to replace older agents with their ease to use and more favorable pharmacodynamic profiles. Increasingly, anesthesiologists are being requested to anesthetize patients who are on some form of anticoagulants and hence it is important to have sound understanding of pharmacology, dosing, monitoring, and toxicity of anticoagulants. We searched the online databases including PubMed Central, Cochrane, and Google Scholar using anticoagulants, perioperative management, anesthetic considerations, and LMWH as keywords for the articles published between 1994 and 2015 while writing this review. In this article, we will review the different classes of anticoagulants and how to manage them in the perioperative settings.

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Platelet Function Testing and Tailored Antiplatelet Therapy

Cited by 37 publications

References 83 publications

Platelet activation after endovascular repair of abdominal aortic aneurysm

Platelet activation after endovascular repair of abdominal aortic aneurysm

Use of thromboelastography to tailor dual-antiplatelet therapy in patients undergoing treatment of intracranial aneurysms with the Pipeline embolization device

Perioperative considerations and management of patients receiving anticoagulants

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