Does Preoperative Platelet Function Predict Bleeding in Patients Undergoing Off Pump Coronary Artery Bypass Surgery?

Area of Science:

• Cardiovascular Surgery
• Hematology
• Clinical Diagnostics

Background:

• Platelet aggregability can be measured using various methods.
• Limited understanding exists regarding the correlation between different platelet function assays and their relationship with bleeding outcomes.

Purpose of the Study:

• To investigate the association between preoperative platelet function tests and perioperative bleeding in patients undergoing coronary artery bypass grafting (CABG).

Main Methods:

• Prospective study of 50 patients undergoing off-pump CABG.
• Preoperative platelet function assessed using VerifyNow®, TEG®, AggreGuide™, Plateletworks®, VASP phosphorylation, and light transmission aggregometry.
• Perioperative bleeding evaluated by hematocrit drop and chest tube drainage.

Main Results:

• Weak correlations were observed between most point-of-care platelet function tests and hematocrit changes.
• Plateletworks® showed a weak correlation with hematocrit drop (r=0.2882, P=0.0470).
• AggreGuide™ and VASP phosphorylation demonstrated weak correlations with chest tube drainage (r=-0.3073, P=0.0317 and r=-0.3187, P=0.0272, respectively).
• Correlations among the four point-of-care tests themselves were also poor.

Conclusions:

• Limited correlation exists among common platelet function tests and between these assays and perioperative bleeding.
• The utility of current platelet function assays in guiding clinical decisions for individual CABG patients remains uncertain.