Net platelet clot strength of thromboelastography platelet mapping assay for the identification of high on-treatment platelet reactivity in post-PCI patients

Cheng, Da‐Chuan; Zhao, Shuo; Hao, Ying

doi:10.1042/bsr20201346

Cited by 6 publications

(9 citation statements)

References 37 publications

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“…In agreement with previous studies [ 22 , 23 ], our study suggests that MA was significantly associated with CHD. MA represented the maximal clot strength and revealed the reactivity of platelets, which is critical in the generation of thrombus [ 24 ]. Application of proper antiplatelet medication and adjustment of MA value within a normal range might reduce the risk of CHD in people with hypercoagulability.…”

Section: Discussionmentioning

confidence: 99%

Association Between Thromboelastography and Coronary Heart Disease

et al. 2022

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Background Thromboelastography (TEG) is a novel blood viscoelasticity detection method revealing blood coagulation status and has been reported to be helpful in predicting clinical outcomes in patients with cardiovascular diseases (CVD). In this study, we aimed to investigate the association between TEG and CVD. Material/Methods A single-center case-control study was performed. Individuals who took TEG tests at Tongji Hospital in Wuhan, China from 2015 to 2019 were included. The nearest-neighbor Mahalanobis matching with replacement, within propensity score calipers of 0.25 was used to control the covariate imbalance between CVD patients and controls. Logistic regression analyses were conducted to assess the relationship between TEG and CVD. Subgroup and sensitivity analyses were performed to evaluate the robustness of the association between TEG and CVD. Results After matching, a total of 151 participants were included in this study, with 83 patients having CVD (49 patients having coronary heart disease [CHD] and 34 patients having an ischemic stroke). By comparison, CHD patients had a significantly higher maximum amplitude (MA) ( P =0.02) than controls. After multivariable adjustment, MA (OR 1.11, 95% CI 1.01–1.24, P =0.04) was independently associated with CHD. The association between MA and CHD remained robust across subgroups and in sensitivity analyses. Conclusions The current study suggests that MA is significantly associated with CHD. Enhanced platelet reactivity as described by high MA might be associated with risk of CHD. The exact role of MA in the measurement of CHD risk needs to be further examined in large-scale prospective cohort studies.

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Section: Discussionmentioning

confidence: 99%

Association Between Thromboelastography and Coronary Heart Disease

et al. 2022

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“…The MA demonstrates the clot strength which can test the effectiveness of P2Y 12 inhibitors and aspirin by platelet activation with ADP. A study found that an MA of > 47 mm was a strong predictor of platelet resistance and adverse events after coronary stenting [6] .…”

Section: Discussionmentioning

confidence: 99%

A Case of Ticagrelor Resistance

Malik

2021

European Journal of Case Reports in Internal Medicine

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Ticagrelor is a directly acting cyclopentyltriazolo-pyrimidine which does not require conversion into an active metabolite. It inhibits the P2Y12 receptors on platelets reversibly. Unlike clopidogrel and prasugrel, resistance to ticagrelor is rarely reported. Various mechanisms have been proposed for this resistance. The case of a 62-year-old man with diabetes who had undergone index percutaneous coronary intervention (PCI) 22 days previously is described. The patient presented to us with stent thrombosis. His primary PCI was successfully carried out with a drug-eluting stent. He showed resistance to ticagrelor on thromboelastography platelet mapping. He responded well to prasugrel (another P2Y12 inhibitor) in combination with aspirin.

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“…Several studies were identified that compared the use of thromboelastography vs. LTA to monitor platelet function in patients with ACS treated with PCI [8,[25][26][27][28][29][30][31], with fewer studies identified comparing thromboelastography vs. VerifyNow ® [26,32]. A list of parameters and their associated assays discussed herein is, described in Table 2.…”

Section: Clinical Validation Of Thromboelastography With Plateletmapp...mentioning

confidence: 99%

“…The current gold standard for determining platelet reactivity, LTA, is time-consuming and requires lengthy laboratory-based sample manipulation and specialist expertise as well as large sample volumes [7,8]. Thromboelastography, VerifyNow, and Multiplate, described elsewhere [6], can be performed by non-technical staff outside the laboratory to provide rapid readouts at the patient bedside [6,9,10].…”

Section: Introductionmentioning

confidence: 99%

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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Net platelet clot strength of thromboelastography platelet mapping assay for the identification of high on-treatment platelet reactivity in post-PCI patients

Cited by 6 publications

References 37 publications

Association Between Thromboelastography and Coronary Heart Disease

Association Between Thromboelastography and Coronary Heart Disease

A Case of Ticagrelor Resistance

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

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