| Title: |
Reduction of Preoperative Waiting Time Before Urgent Surgery for Patients on P2Y 12 Inhibitors Using Multiple Electrode Aggregometry: A Retrospective Study |
| Authors: |
Michaël Hardy; Camie Dupuis; Anne-Sophie Dincq; Hugues Jacqmin; Thomas Lecompte; François Mullier; Sarah Lessire |
| Source: |
Journal of Clinical Medicine, Vol 9, Iss 2, p 424 (2020) |
| Publisher Information: |
MDPI AG |
| Publication Year: |
2020 |
| Collection: |
Directory of Open Access Journals: DOAJ Articles |
| Subject Terms: |
multiple electrode aggregometry; multiplate; p2y 12 inhibitors; clopidogrel; prasugrel; ticagrelor; preoperative; perioperative; urgent surgery; Medicine |
| Description: |
P2Y 12 inhibitor discontinuation is essential before most surgical interventions to limit bleeding complications. Based on pharmacodynamic data, fixed discontinuation durations have been recommended. However, as platelet function recovery is highly variable among patients, a more individualized approach based on platelet function testing (PFT) has been proposed. The aim of this retrospective single-centre study was to determine whether PFT using whole blood adenosine diphosphate−multiple electrode aggregometry (ADP−MEA) was associated with a safe reduction of preoperative waiting time. Preoperative ADP−MEA was performed for 29 patients on P2Y 12 inhibitors. Among those, 17 patients underwent a coronary artery bypass graft. Twenty one were operated with an ADP−MEA ≥ 19 U (quantification of the area under the aggregation curve), and the waiting time was shorter by 1.6 days (median 1.8 days, IQR 0.5−2.9), by comparison with the current recommendations (five days for clopidogrel and ticagrelor, seven days for prasugrel). Platelet function recovery was indeed highly variable among individuals. With the 19 U threshold, high residual platelet inhibition was associated with perioperative platelet transfusion. These results suggest that preoperative PFT with ADP−MEA could help reduce waiting time before urgent surgery for patients on P2Y 12 inhibitors. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://www.mdpi.com/2077-0383/9/2/424; https://doaj.org/toc/2077-0383; https://doaj.org/article/f39cea1b43bf436b8f4a3e54ad4db9fe |
| DOI: |
10.3390/jcm9020424 |
| Availability: |
https://doi.org/10.3390/jcm9020424; https://doaj.org/article/f39cea1b43bf436b8f4a3e54ad4db9fe |
| Accession Number: |
edsbas.2D875B9 |
| Database: |
BASE |