Viscoelastic Hemostatic Assays and Platelet Function Testing in Patients with Atherosclerotic Vascular Diseases

Abstract

Platelets play crucial role in acute vascular atherosclerotic diseases, including myocardial infarction and stroke. Additionally, platelet aggregation is a key target of antiplatelet agents, forming the keystone of pharmacotherapy of various atherosclerotic cardiovascular diseases. Thromboelastography and thromboelastometry, representing currently available viscoelastic hemostatic assays (VHA), are designed as whole blood, real-time analyzers of clot formation and clot resolution. These assays could, in theory, overcome some limitations of currently available platelet function testing assays. This article reviews the current experience with the use of VHA for platelet function testing and for monitoring of the response to antiplatelet therapy.

Rotational thromboelastometry in patients with type 2 diabetes and mild COVID-19 pneumonia: A pilot prospective study

“…Although aspirin therapy could, in theory, impact the ROTEM® parameters, [ 19 ] there were no significant differences in this therapy between T2D and nondiabetic patients, and it is unlikely that aspirin alone significantly affected our ROTEM® testing, as the sensitivity of standard ROTEM® for drug-induced platelet dysfunction is low. [ 20 ] Additionally, we did not perform ROTEM® analysis with FIBTEM® reagent to assess fibrin polymerization in a functional way, and healthy blood donors enrolled in the control group were slightly younger compared to controls. Considering these limitations, our results should be interpreted with caution, and should be definitely confirmed in future studies on larger patient samples.…”

The Applicability of Thromboelastography in Acute Ischemic Stroke: A Literature Review

“…17,19 TEG PlateletMapping is used to evaluate the inhibitory effect of antiplatelet drugs (e.g., clopidogrel and aspirin), by measuring the percentage of platelet aggregation in the presence of adenosine diphosphate (ADP) and arachidonic acid (AA), respectively. 20,21 TEG 6s is a fully automated, portable device, using a four-channel microfluidics cartridge. The whole blood sample is pipetted into the entry port in the cartridge.…”

Clinical Application of Thromboelastography in Acute Ischemic Stroke

“…Meanwhile, TEG has been wildly used in bleeding events in coronary surgeries, postpartum hemorrhage, and intracerebral hemorrhage. 4 , 6 – 45 However, only a few studies investigated the role of TEG in bleeding events in AIS patients. Compared to CCTs, the parameter R is supposed to be superior to indicating the symptomatic intracranial hemorrhage after endovascular therapy.…”

“…It is suggested that each patient should have a baseline TEG value to obtain their personalized reference value before treatment. 39 In summary, all laboratory assessments of hemostasis for the clinic should be interpreted cautiously, considering each piece of information from physical examination and disease history. 23 The Application of TEG in AIS…”