Correlation between PlateletWorks® and PFA-100® for Measuring Platelet Function before Urgent Surgery in Patients with Chronic Antiplatelet Therapy

Abstract

Hemostasis is crucial for reducing bleeding during surgical procedures. The points-of-care based on the platelet function test could be useful to minimize the complications related to chronic antiplatelet therapy during surgery. The present study is aimed at comparing two point-of-care platelet function devices—Platelet Function Analyzer PFA-100® (Siemens Canada, Mississauga, ON, Canada) and Plateletworks®(Helena Laboratories, Beaumont, TX, USA). Our objective is to evaluate if they provide comparable and useful information to manage anti-aggregate patients before surgery. We included patients with a femoral fracture receiving chronic antiplatelet therapy and a median age of 89 years (range from 70 to 98). A platelet function evaluation was performed on all patients before surgery using both devices—Plateletworks® and PFA-100®. The correlation between Plateletworks® and PFA-100® was performed using Cohen’s Kappa coefficient. Twenty consecutive patients participated in the trial; 16 patients were under treatment with 75 mg/day of clopidogrel, three with >300 mg/day of acetylsalicylic acid (ASA), and only one was in treatment with both antiplatelet agents. Cohen’s Kappa coefficient was 0.327 comparing PFA-100®-ADP (adenosine diphosphate) and Plateletworks® and, 0.200 comparing PFA-100®-EPI (epinephrine) and Plateletworks®. In conclusion, we found a weak concordance comparing PFA-100® and Plateletworks®. This could partially be due to the advanced age of the included patients. However, given the limited sample size, more studies are necessary to confirm these results.

Harmonizing platelet function analyzer testing and reporting in a large laboratory network

“…For comparison, some CT NRRs reported in the contemporary 6,16–29 and original literature 30–53 are shown in Figure 3. In most instances, these NRRs differ from each other and also from the manufacturer ranges, especially for C/ADP.…”

“…The Siemens product information CT NRRs are shown by the green horizontal dashed lines. Figure A shows NRRs from some contemporary literature as obtained from the recent literature search (see Methods), and reflecting information from the past 3 years 6,16–29 . Figure B shows NRRs from some early literature as otherwise reviewed in Reference 10 30–53 .…”

Aspirin Resistance in Vascular Disease: A Review Highlighting the Critical Need for Improved Point-of-Care Testing and Personalized Therapy

“…However, a recent study published by Anaya et al comparing PFA-100 with Platelet Works recorded weak correlation between the two. Notably, the author did not investigate LTA in their study [ 94 ]. Thus far, only one study has sought to determine a cut-off value for diagnosing patients with aspirin resistance using Platelet Works [ 93 ].…”