Temperature effects on haemostasis in whole blood from ticagrelor- and aspirin-treated patients with acute coronary syndrome

Kander, Thomas; Brokopp, Jens; Erlinge, David; Lood, Christian; Schött, Ulf

doi:10.3109/00365513.2014.965735

Cited by 14 publications

(19 citation statements)

References 44 publications

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“…The authors explained that Sonoclot and thromboelastography fail to detect changes in platelet activation, whereas flow cytometry is designed to do this. Similar conflicting results were found in respect to TH and ticagrelor based on in vivo and in vitro designs . This finding is particularly interesting due to the unique study design, in which researchers eliminated the possible risk of poor intestinal absorption on the outcome .…”

Section: Th and Asamentioning

confidence: 58%

“…The effect of P2Y 12 ‐antagonists can be detected with flow cytometry–based VASP analysis and, as described above, it was decreased when clopidogrel was given during mild hypothermia . This can explain the discrepant findings between Multiplate and Sonoclot with VASP analyses in the study conducted by Kander et al . Moreover, a strong correlation between gastric emptying and VASP during hypothermia indicated that delayed gastric emptying could be responsible for the limited ticagrelor effect.…”

Section: Th and P2y12 Inhibitorsmentioning

confidence: 95%

“…Mild hypothermia was related to enhanced platelet activation defined as upregulation of PAC‐1 and P‐selectin on the platelet surface measured with flow cytometry. As discussed above, the powerful platelet inhibition, exerted by ASA and P2Y 12 blockade, is not detectable by Sonoclot in vivo analyses . This finding is particularly interesting due to the unique study design, in which researchers eliminated the possible risk of poor intestinal absorption on the outcome .…”

Section: Th and Asamentioning

confidence: 96%

“…Sonoclot analysis, which is a platelet function assessment technique combined with viscoelastic test evaluating the clotting mechanism, is not dedicated to measure platelet reactivity and efficacy of antiplatelet drugs. For example, platelet inhibition, exerted by ASA and P2Y 12 blockade, is not detectable by Sonoclot in vivo analyzes . Finally, data on utility of the available tests for platelet activation assessment under TH conditions are scant.…”

Section: Platelet Functionsmentioning

confidence: 99%

See 3 more Smart Citations

Effectiveness of Antiplatelet Drugs Under Therapeutic Hypothermia: A Comprehensive Review

Eyileten

Pordzik

Siller-Matula

et al. 2019

Clin Pharma and Therapeutics

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Out‐of‐hospital cardiac arrest is among the most frequent causes of death worldwide. Immediate intervention, as well as dual antiplatelet therapy consisting of acetylsalicylic acid and a P2Y12 inhibitor is often recommended. In line with the growing number of reports on cardiac arrest treatment, therapeutic hypothermia (TH) has been proposed for unconscious patients to improve neurological outcomes. Nevertheless, studies report controversial and often discrepant results on the effect of hypothermia on blood coagulability and platelet reactivity. In this review, we summarize the knowledge on platelet function under diverse hypothermic conditions. Additionally, we review the current literature on the effect of systemic hypothermia on pharmacokinetic and pharmacodynamic properties of antiplatelet agents. It has been shown that TH can alter the effectiveness of antiplatelet agents, including P2Y12 inhibitors, through multiple mechanisms, hence, special attention should be paid while implementing antiplatelet therapy in patients under TH conditions.

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Section: Th and Asamentioning

confidence: 58%

Section: Th and P2y12 Inhibitorsmentioning

confidence: 95%

Section: Th and Asamentioning

confidence: 96%

Section: Platelet Functionsmentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness of Antiplatelet Drugs Under Therapeutic Hypothermia: A Comprehensive Review

Eyileten

Pordzik

Siller-Matula

et al. 2019

Clin Pharma and Therapeutics

View full text Add to dashboard Cite

show abstract

“…This study concluded that, operation time, diameter, length or number of stent showed no significant difference in the groups. Interventional operation itself also has important influence on the function of blood coagulation system (14). Test time of blood coagulation, postoperative CK-MB, cTnI and BNP levels in observation group are significantly lower than that of control group.…”

Section: Discussionmentioning

confidence: 99%

The value of Sonoclot detection technology to guide the clinical medication of the perioperative anticoagulation and antiplatelet therapy in patients with acute myocardial infarction undergoing emergent PCI

Wuxiao

Lai

Chen

et al. 2017

Experimental and Therapeutic Medicine

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The value of Sonoclot detection technology to guide the clinical medication of the perioperative anticoagulation and antiplatelet therapy in patients with acute myocardial infarction (AMI) undergoing emergent percutaneous coronary intervention (PCI) was estimated. One hundred and twenty-eight patients were randomly divided into control group and observation group with 64 cases in each group. Control group adopted routine blood coagulation indexes, including prothrombin time, activated partial thromboplastin time, fibrinogen and plasma thrombin time, platelet count and platelet aggregation turbidity analysis; observation group adopted Sonoclot detection technology, including activated clotting time, coagulation rate and platelet function. Anticoagulant therapy selected was of low molecular weight heparin calcium perioperatively, intraoperative unfractionated heparin, and clopidogrel (75 mg) combined with aspirin enteric-coated tablets (100 mg) as antiplatelet drugs. The therapy was administered in accordance with blood coagulation results. The blood coagulation time, postoperative creatine kinase isoenzyme MB, cardiac troponin I and B-type natriuretic peptide levels in the observation group are significantly lower than those in the control group (P<0.05) though the operating time and specifications of the stenting did not show any significant difference (P>0.05). The incidence of recurrent myocardial infarction, microembolism, acute and subacute thrombosis and bleeding events in the observation group are significantly lower than those in the control group (P<0.05). In the control group, there is no difference in the coagulation indexes of the patients with thrombosis events or bleeding events or no event (P>0.05). Whereas, in the observation group, there is significant difference in coagulation indexes of the patients with thrombosis events or bleeding events or no event (P<0.05). In conclusion, Sonoclot detection technology instructs emergent PCI treatment in AMI patients to shorten the detection time of blood coagulation, reduce the degree of myocardial injury, reduce the incidence of perioperative thrombosis and bleeding events. Furthermore, it has great value in guiding the clinical medication of anticoagulation and antiplatelet therapy.

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Efficacy of enteral ticagrelor in hypothermic patients after out-of-hospital cardiac arrest

et al. 2015

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IntroductionDelivery of crushed ticagrelor via a nasogastric tube is a widely spread off-label use in unconscious patients following out-of-hospital cardiac arrest (OHCA). Notwithstanding the importance of a potent dual antiplatelet therapy in these patients, the efficacy of crushed ticagrelor after OHCA has not been established yet.MethodsIn a prospective, single-center, observational trial, 38 consecutive MI patients after OHCA were included. 27 patients (71.1 %) underwent mild induced hypothermia. The primary outcome was platelet inhibition at 24h measured by impedance aggregometry.ResultsThere was sufficient platelet inhibition in most patients after OHCA. In all hypothermic patients, there was an adequate platelet inhibition by ticagrelor at 24 h (p < 0.001). 15 patients (39.5 %) had significant gastroesophageal reflux and one patient with significant reflux had inadequate platelet inhibition at 24 h. There were no stent thrombosis or recurrent atherothrombotic events in these patients.ConclusionAdministration of crushed ticagrelor via a nasogastric tube reliably inhibited platelet function in vitro and in vivo regardless of the presence of hypothermia in MI patients. Thus, platelet inhibition can be reliably achieved in MI patients during neuroprotective hypothermia following OHCA.

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Temperature effects on haemostasis in whole blood from ticagrelor- and aspirin-treated patients with acute coronary syndrome

Cited by 14 publications

References 44 publications

Effectiveness of Antiplatelet Drugs Under Therapeutic Hypothermia: A Comprehensive Review

Effectiveness of Antiplatelet Drugs Under Therapeutic Hypothermia: A Comprehensive Review

The value of Sonoclot detection technology to guide the clinical medication of the perioperative anticoagulation and antiplatelet therapy in patients with acute myocardial infarction undergoing emergent PCI

Efficacy of enteral ticagrelor in hypothermic patients after out-of-hospital cardiac arrest

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