Comparison of modified Thrombelastograph and Plateletworks whole blood assays to optical platelet aggregation for monitoring reversal of clopidogrel inhibition in elective surgery patients

Craft, Robert M.; Chavez, Jack J.; Snider, Carolyn C.; Muenchen, Robert A.; Carroll, Roger C.

doi:10.1016/j.lab.2005.03.010

Cited by 70 publications

(40 citation statements)

References 19 publications

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“…Дан-ная методика предлагается к использованию в кар-диохирургии из-за быстроты, полной автоматизиро-ваности и простоты в использовании. В то же время по-вседневное использование данной методики ограниче-но недостаточной корреляцией ее результатов с хи-рургическими осложнениями [32].…”

Section: Monitoring Of Antiplatelet Therapy Effectiveness контроль эфunclassified

Monitoring of the Effectiveness of Antiplatelet Therapy in Cardiology Practice

Пучиньян

Furman

Malinova

et al. 2017

Racionalʹnaâ farmakoterapiâ v kardiologii

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ВведениеАктивация тромбоцитов -ключевое звено атерот-ромбоза и, следовательно, целого ряда угрожающих жизни состояний, им обусловленных, в том числе, ост-рого коронарного синдрома (ОКС), включающего ин-фаркт миокарда (ИМ) с подъемом или без подъема ST и нестабильную стенокардию. Поэтому подавле-ние/снижение агрегационной активности тромбоци-тов является «краеугольным камнем» терапии и про-филактики атеротромбоза, а антитромбоцитарные (антиагрегантные) препараты (ААП) -обязательный компонент терапии и профилактики целого ряда сер-дечно-сосудистых заболеваний, в основе патогенеза ко-торых лежит атеротромбоз [1,2].Как показано в большом количестве исследова-ний, мета-анализов и систематизированных обзоров, назначение ААП больным ОКС способствует улучшению прогноза пациента независимо от выбранной страте-гии лечения (инвазивной или консервативной). При-менение ААП должно начинаться в как можно более ранние сроки развития ОКС на догоспитальном или ста-ционарном этапах оказания помощи, и должно про-должаться на протяжении всей госпитализации и после выписки из стационара. Контроль эффективности лекарственной терапии является одной из наиболее обсуждаемых проблем в повседневной клинической работе. Появление новых препаратов, методов анализа, стандартов, протоколов ведения, и клинических рекомендаций повышает информацион-ную нагрузку на практикующих врачей, требует существенных затрат сил и времени для самообразования. Цель обзора -в краткой форме помочь практикующим врачам получить необходимые сведения по проблеме контроля антитромбоцитарной терапии. В обзоре воедино све-дены данные современных клинических рекомендаций по антитромбоцитарной терапии у больных ишемической болезнью сердца, приве-дены сведения о существующих подходах к контролю антитромбоцитарной терапии, изложенные в клинических рекомендациях и консен-сусах специалистов. Представлены сведения о наиболее распространенных современных методах контроля эффективности антитромбоци-тарной терапии.Ключевые слова: ишемическая болезнь сердца, антитромбоцитарная терапия, аспирин, клопидогрел, резистентность, контроль. Monitoring of the effectiveness of drug therapy is one of the most debated issues in everyday clinical practice. The emergence of new drugs, methods of analysis, standards, management protocols, and clinical guidelines increases the information load on practitioners and requires a significant investment of time and efforts for self-education. The purpose of the review is to help practitioners in summary form to obtain the necessary information on the issue of control of antiplatelet therapy. The review brings together data from current clinical recommendations on antiplatelet therapy in patients with ischemic heart disease, gives information of existing approaches to control of antiplatelet therapy specified in the guidelines and the consensuses of experts. It presents information on the most common modern methods of monitoring of the antiplatelet therapy effectiveness.

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Section: Monitoring Of Antiplatelet Therapy Effectiveness контроль эфunclassified

Monitoring of the Effectiveness of Antiplatelet Therapy in Cardiology Practice

Пучиньян

Furman

Malinova

et al. 2017

Racionalʹnaâ farmakoterapiâ v kardiologii

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“…Therefore, this technique is a dynamic measure of clot formation, strength, and lysis. In clinical setting, WB is typically used in TEG® [24][25][26][27][28] . It can be citrated or naïve, uncitrated blood.…”

Section: Teg®mentioning

confidence: 99%

“…The results showed that the current "one size fits all" dual treatment regimen of clopidogrel and aspirin fails to prevent bleeding and ischaemia as it assumes that all patients experience the same degree of platelet activation and haemostasis. In fact, several studies on the pharmacodynamics of clopidogrel have shown vast variability in responsiveness across patients 26,28,43) . The results obtained by Elliott et al discussed above also indicated that TEG® of WB could be used as a screening tool in patients at risk of vascular disease.…”

Section: Teg®mentioning

confidence: 99%

Novel Diagnostic and Monitoring Tools in Stroke: an Individualized Patient-Centered Precision Medicine Approach

Villiers

Swanepoel

Bester

et al. 2016

J Atheroscler Thromb

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Central to the pathogenesis of ischaemic stroke are the normally protective processes of platelet adhesion and activation. Experimental evidence has shown that the ligand-receptor interactions in ischaemic stroke represent a thrombo-inflammatory cascade, which presents research opportunities into new treatment. However, as anti-platelet drugs have the potential to cause severe side effects in ischaemic stroke patients (as well as other vascular disease patients), it is important to carefully monitor the risk of bleeding and risk of thrombus in patients receiving treatment. Because thrombo-embolic ischaemic stroke is a major health issue, we suggest that the answer to adequate treatment is based on an individualized patient-centered approach, inline with the latest NIH precision medicine approach. A combination of viscoelastic methodologies may be used in a personalized patient-centered regime, including thromboelastography (TEG®) and the lesser used scanning electron microscopy approach (SEM). Thromboelastography provides a dynamic measure of clot formation, strength, and lysis, whereas SEM is a visual structural tool to study patient fibrin structure in great detail. Therefore, we consider the evidence for TEG® and SEM as unique means to confirm stroke diagnosis, screen at-risk patients, and monitor treatment efficacy. Here we argue that the current approach to stroke treatment needs to be restructured and new innovative thought patterns need to be applied, as even approved therapies require close patient monitoring to determine efficacy, match treatment regimens to each patient's individual needs, and assess the risk of dangerous adverse effects. TEG® and SEM have the potential to be a useful tool and could potentially alter the clinical approach to managing ischaemic stroke. As envisaged in the NIH precision medicine approach, this will involve a number of role players and innovative new research ideas, with benefits that will ultimately only be realized in a few years. Therefore, with this ultimate goal in mind, we suggest that an individualized patient-orientated approach is now available and therefore already within our ability to use. J Atheroscler Thromb, 2016; 23: 493-504.

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“…Results are available in minutes and without any manipulation of blood sample [124] . This method has showed a relationship with LTA, VerifyNow system and Thromboelastography [125,126] and may be used to monitor antiplatelet therapy [127] . Plateletworks gives information about both platelet count and function within an acute care situation.…”

Section: Plateletworkmentioning

confidence: 99%

Assessment of platelet function: Laboratory and point-of-care methods

Paniccia¹

2014

WJTM

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In the event of blood vessel damage, human platelets are promptly recruited on the site of injury and, after their adhesion, activation and aggregation, prevent blood loss with the formation of a clot. The consequence of abnormal regulation can be either hemorrhage or the development of thrombosis. Qualitative and/or quantitative defects in platelets promote bleeding, whereas the residual reactivity of platelets, despite antiplatelet therapies, play an important role in promoting arterial thrombotic complications. Platelet function is traditionally assessed to investigate the origin of a bleeding syndrome, to predict the risk of bleeding prior surgery or during pregnancy or to monitor the efficacy of antiplatelet therapy in thrombotic syndromes that, now, can be considered a new discipline. "Old" platelet function laboratory tests such as the evaluation of bleeding time and the platelet aggregation analysis in platelet-rich plasma are traditionally utilized to aid in the diagnosis and management of patients with platelet and hemostatic disorders and used as diagnostic tools both in bleeding and thrombotic diathesis in specialized laboratories. Now, new and renewed automated systems have been introduced to provide a simple, rapid assessment of platelet function including point of care methods. These new methodologies are also suitable for being used in non-specialized laboratories and in critical area for assessing platelet function in whole blood without the requirement of sample processing. Some of these methods are also beginning to be incorporated into routine clinical use and can be utilized as not only as first panel for the diagnosis of platelet dysfunction, but also for monitoring anti-platelet therapy and to potentially assess risk of both bleeding and/or thrombosis.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Platelets; Method; Test; Point of care testing; Laboratory assessment; Bleeding; Thrombosis; Platelet function Core tip: This review discussed the scenario of available platelet function laboratory and point-of-care methods suitable in different clinical setting. As this matter has become of crucial importance in the bleeding management and for monitoring antiplatelet therapies, improved ability to assess platelet function in a timely and efficient manner is essential. Traditional platelet function methods, requiring a fair degree of expertise, have been limited to specialized laboratory. Many efforts have been carried out for improving platelet function assays for centralized laboratory, such as different point-of-care testing methodologies have been developed. Moreover, different guidelines and recommendations for their method standardization are growing.

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Comparison of modified Thrombelastograph and Plateletworks whole blood assays to optical platelet aggregation for monitoring reversal of clopidogrel inhibition in elective surgery patients

Cited by 70 publications

References 19 publications

Monitoring of the Effectiveness of Antiplatelet Therapy in Cardiology Practice

Monitoring of the Effectiveness of Antiplatelet Therapy in Cardiology Practice

Novel Diagnostic and Monitoring Tools in Stroke: an Individualized Patient-Centered Precision Medicine Approach

Assessment of platelet function: Laboratory and point-of-care methods

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