Detection of individual responses to clopidogrel: Validation of a novel, rapid analysis using thrombelastography 6s

Olechowski, Bartosz; Dalton, Richard; Khanna, Vikram; Ashby, Alexander; Vavyla, Maria; Mariathas, Mark; Harris, Scott; Nicholas, Zoe; Mahmoudi, Michael; Curzen, Nick

doi:10.1111/1755-5922.12433

Cited by 13 publications

(6 citation statements)

References 34 publications

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“…The most recent TEG ® device that can run the PlateletMapping ® function is the TEG ® 6s. Although most of the data reported in the present study is based on the older TEG ® 5000, readings from the TEG ® 5000 andTEG ® 6s devices have been shown to be well correlated when used in the settings of cardiology (including intra-individual reproducibility) [50], cardiac surgery [51] and trauma [52]. The present review identified several studies from East Asian centers that cited similar performance of thromboelastography to the gold-standard assay (LTA) in terms of identifying HTPR and predicting clinical outcomes, with the largest study identified in this regard [25] showing a strong correlation between thromboelastography and LTA parameters.…”

Section: Discussionmentioning

confidence: 71%

The Use of Thromboelastography in Percutaneous Coronary Intervention and Acute Coronary Syndrome in East Asia: A Systematic Literature Review

Hartmann²,

Tang³

et al. 2022

JCM

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Dual antiplatelet therapy (DAPT), alongside percutaneous coronary intervention (PCI), is central to the prevention of ischemic events following acute coronary syndrome (ACS). However, response to therapy can vary due to several factors including CYP2C19 gene variation, which shows increased prevalence in East Asian populations. DAPT responsiveness can be assessed using techniques such as light transmission aggregometry (LTA), VerifyNow® and thromboelastography with the PlateletMapping® assay, and there is increasing focus on the utility of platelet function testing to guide individualized treatment. This systematic literature review of one English and three Chinese language databases was conducted to evaluate the evidence for the utility of thromboelastography in ACS/PCI in East Asia. The search identified 42 articles from the English language and 71 articles from the Chinese language databases which fulfilled the pre-determined inclusion criteria, including 38 randomized controlled trials (RCTs). The identified studies explored the use of thromboelastography compared to LTA and VerifyNow in monitoring patient responsiveness to DAPT, as well as predicting ischemic risk, with some studies suggesting that thromboelastography is better able to detect low DAPT response than LTA. Other studies, including one large RCT, described the use of thromboelastography in guiding the escalation of DAPT, with some evidence suggesting that such protocols reduce ischemic events without increasing the risk of bleeding. There was also evidence suggesting that thromboelastography can be used to identify individuals with DAPT hyporesponsiveness genotypes and could potentially guide treatment by adjusting therapy in patients depending on responsiveness.

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Section: Discussionmentioning

confidence: 71%

The Use of Thromboelastography in Percutaneous Coronary Intervention and Acute Coronary Syndrome in East Asia: A Systematic Literature Review

Hartmann²,

Tang³

et al. 2022

JCM

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“…Furthermore, the TEG 6s device uses a disposable four-channel cartridge to process whole blood samples for assays, and this simplified assay procedure increases the ease of use and substantially reduces the time required for results compared with the TEG 5000 device. 27 28 The TEG 6s device has been tested and validated for the assessment of coagulation dynamics in cardiology patients, 29 trauma patients, 30 and in cardiothoracic surgery, 31 showing high within-device reliability, good diagnostic accuracy, and a close correlation of results with the previous generation TEG 5000 device. 32 With the TEG 6s device, the PlateletMapping assay comes as a single cartridge, containing all necessary components to evaluate the activity of the AA and ADP pathways.…”

Section: The Teg Platelet Mapping Assaymentioning

confidence: 99%

Modified Thromboelastography for Peri-interventional Assessment of Platelet Function in Cardiology Patients: A Narrative Review

Hartmann

Curzen

2022

Semin Thromb Hemost

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Viscoelastic testing (VET), such as thromboelastography, can measure whole blood coagulation dynamics in real time and is used across a range of clinical settings, including cardiac surgery, liver transplant, and trauma. The use of modified thromboelastography with platelet function assessment (TEG(R) PlateletMapping(R) Assay) can provide an analysis of platelet contribution to hemostasis, including the contribution of the P2Y12 receptor and thromboxane pathway to platelet function. The TEG PlateletMapping Assay has shown high correlation with the current gold standard test of platelet function, light transmission aggregometry, to measure arachidonic acid and adenosine diphosphate agonist-induced platelet activation. Studies have also shown comparable results with other whole blood platelet function tests. In this review, we explore the clinical applications of modified thromboelastography with platelet function assessment. This includes guiding dual antiplatelet therapy in relation to cardiac procedures, such as percutaneous coronary interventions, transcatheter aortic valve replacement, and left atrial appendage closure. We also explore the developing use of thromboelastography in the emergency care setting of coronavirus disease 2019, which is commonly associated with a hypercoagulable and hypofibrinolytic state. Despite a general lack of high-quality, grade 1 evidence regarding the use of modified thromboelastography with platelet function assessment in these disease areas, the ability of the TEG PlateletMapping Assay to measure global hemostasis and platelet reactivity rapidly and to view and evaluate results at the point of care makes it a promising area for further study for managing patient treatment and optimizing hemostatic therapy.

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“…A more balanced discussion should mention the 3 recent method validation studies. [12][13][14] It could benefit from including studies in which Plate-letMapping testing compared favorably with other tests. 8,15,16 It could provide more balanced views, including some published in this journal, to the specific issues raised about Plate-letMapping analysis, 11 and it should mention the described potential value of PlateletMapping in various clinical settings.…”

Section: Accuracy and Clinicalmentioning

confidence: 99%

External Quality Assurance of Platelet Function Assays: Results of the College of American Pathologists Proficiency Testing Program

Hartmann

2019

Archives of Pathology &Amp; Laboratory Medicine

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Detection of individual responses to clopidogrel: Validation of a novel, rapid analysis using thrombelastography 6s

Abstract: Thrombelastography 6s is a rapid, easy to use and accurate test of ADP-induced clotting using TEG 5000 as a reference. A novel parameter, AUC15, is a viable, time-saving option for this test and has potential value in personalized P2Y12 inhibitor therapy.

Cited by 13 publications

References 34 publications

The Use of Thromboelastography in Percutaneous Coronary Intervention and Acute Coronary Syndrome in East Asia: A Systematic Literature Review

The Use of Thromboelastography in Percutaneous Coronary Intervention and Acute Coronary Syndrome in East Asia: A Systematic Literature Review

Modified Thromboelastography for Peri-interventional Assessment of Platelet Function in Cardiology Patients: A Narrative Review

External Quality Assurance of Platelet Function Assays: Results of the College of American Pathologists Proficiency Testing Program

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