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Optimal timing of clopidogrel discontinuation in Japanese patients: platelet aggregation test using the VerifyNow®

Hiroki Takiuchi1, Kazuo Tanemoto2

  • 1Department of Cardiovascular Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan. hirokit22@gmail.com.

General Thoracic and Cardiovascular Surgery
|August 24, 2015
PubMed

Insights

Platelet function recovers 5 days after stopping clopidogrel, suggesting shorter pre-surgery intervals. The VerifyNow P2Y12 assay helps predict bleeding risk.

Area of Science:

  • Cardiology
  • Pharmacology
  • Surgical Risk Assessment

Background:

  • Current guidelines recommend 7-14 days without antiplatelet therapy before major surgery.
  • Limited data exists on clopidogrel cessation timing and postoperative bleeding in Japanese patients.

Purpose of the Study:

  • To determine optimal clopidogrel discontinuation timing before elective surgery using the VerifyNow® P2Y12 assay.
  • To evaluate the relationship between preoperative platelet function and postoperative bleeding risk.

Main Methods:

  • Study 1: Monitored platelet function (P2Y12 reaction units) every other day after clopidogrel cessation in cardiac surgery patients.
  • Study 2: Correlated preoperative platelet function (VerifyNow P2Y12 and aspirin reaction units) with postoperative bleeding.

Main Results:

  • Platelet function significantly recovered by Day 5 after clopidogrel discontinuation (mean PRU increased from 186 to 283).
  • Mean PRU exceeded the 230 cutoff on Day 5.
  • A slight inverse correlation was observed between preoperative aspirin reaction units and bleeding in specific valve and bypass surgeries.

Conclusions:

  • Platelet aggregation recovers by 5 days post-clopidogrel cessation.
  • The 7-14 day discontinuation interval may be shortened.
  • The VerifyNow assay is a valuable tool for predicting perioperative bleeding risk.
Abstract

Keywords:
Clopidogrel cessationPlatelet functionVerifyNow assay

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