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Platelet Reactivity Unit in Predicting Risk of Bleeding in Patients Undergoing Coronary Artery Bypass Graft Surgery
Zaid Altheeb1, Ahmad Sbitan, Martin Shabiah
11Department of Medicine, Saint Joseph's Regional Medical Center/New York Medical College, Paterson, NJ; 2Department of Medicine, Saint Michael's Medical Center/New York Medical College, Newark, NJ; and 3Cardiology Division, Westchester Medical Center/New York Medical College, Valhalla, NY.
Insights
Postoperative bleeding after coronary artery bypass graft surgery (CABGS) is common. Platelet reactivity unit (PRU) values between 180-200 may predict bleeding risk, especially in patients on dual antiplatelet therapy.
Area of Science:
- Cardiology
- Hematology
- Surgical Complications
Background:
- Postoperative bleeding is a frequent complication following cardiac surgery, leading to substantial transfusion rates in the US and Europe.
- The precise correlation between platelet reactivity and bleeding outcomes after coronary artery bypass graft surgery (CABGS) remains incompletely understood.
Purpose of the Study:
- To investigate the association between preoperative platelet reactivity, measured by Platelet Reactivity Unit (PRU) values, and the incidence of postoperative bleeding in patients undergoing CABGS.
- To determine if PRU values can serve as a predictive marker for bleeding complications.
Main Methods:
- Retrospective analysis of 238 patients who underwent successful CABGS.
- Preoperative Platelet Reactivity Unit (PRU) values were assessed to measure platelet reactivity.
- Postoperative bleeding events were meticulously recorded and analyzed.
Main Results:
- A PRU range of 180-200 was found to be significantly associated with an increased likelihood of postoperative bleeding (P = 0.004).
- This association was particularly pronounced in patients receiving dual antiplatelet therapy (aspirin and clopidogrel).
Conclusions:
- Preoperative PRU values offer a potential method for assessing platelet reactivity and antiplatelet drug responsiveness.
- Stratifying patients based on PRU values may help identify individuals at higher risk of postoperative bleeding after CABGS, especially those on dual antiplatelet therapy.
Abstract:
Bleeding is a common complication of cardiac surgery, accounting for a significant proportion of the total transfusions performed in the United States and Europe. The relationship between platelet reactivity, bleeding, and other adverse events after coronary artery bypass graft surgery (CABGS) has been incompletely characterized. This study investigated the relationship between platelet reactivity and bleeding as a clinical outcome after successful CABGS. A total of 238 patients who underwent CABGS were retrospectively followed for postoperative bleeding. Platelet reactivity unit (PRU) values for all patients were obtained preoperatively to assess the platelet reactivity. The data showed that a range of 180-200 PRU suggests the likelihood of bleeding after CABGS (P = 0.004), with a statistically significant association only for dual antiplatelet therapy with aspirin and clopidogrel. In conclusion, by using PRU values as a method to assess platelet reactivity and antiplatelet responsiveness, our findings suggest that it may be possible to stratify patients undergoing CABGS for the risk of postoperative bleeding particularly patients on dual antiplatelet therapy.
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