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Updated: Apr 1, 2026
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Predicting Bleeding Risk by Platelet Function Testing in Patients Undergoing Heart Surgery
Wiktor Kuliczkowski1, Joanna Sliwka2, Jacek Kaczmarski2
1Department of Cardiology, Wroclaw Medical University, Wrocław, Poland.
Insights
Platelet function testing can predict bleeding after heart surgery. An ASPI test value below specific thresholds may indicate higher postoperative drainage or need for blood transfusions in CABG patients.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Clinical Diagnostics
Background:
- Predicting bleeding after coronary artery bypass grafting (CABG) is crucial for improving patient outcomes.
- Current methods for assessing bleeding risk in CABG patients have limitations.
Purpose of the Study:
- To investigate the association between platelet function tests and postoperative bleeding risk in patients undergoing CABG.
- To evaluate the predictive value of arachidonic acid (ASPI Test) and adenosine diphosphate (ADP Test) in assessing bleeding complications.
Main Methods:
- Retrospective analysis of 478 patients undergoing CABG, including those on aspirin and/or clopidogrel.
- Platelet aggregation was measured using the ASPI Test and ADP Test via multiple-electrode aggregometry before surgery.
- Clinical outcomes, including postoperative drainage and red blood cell concentrate transfusion, were recorded.
Main Results:
- An ASPI Test value below 407 AUC*min was associated with increased postoperative drainage in the overall study group.
- In CABG-only patients, an ASPI Test value below 271 AUC*min predicted the need for red blood cell concentrate transfusion.
- The ADP Test did not show prognostic utility for bleeding risk in patients who stopped clopidogrel within 5 days before surgery.
Conclusions:
- The ASPI Test may serve as a valuable tool for predicting postoperative bleeding complications after heart surgery.
- Specific ASPI Test thresholds can help identify patients at higher risk for excessive drainage or transfusion requirements following CABG.
Background:
Predicting bleeding events in patients with coronary artery bypass grafting (CABG) represents an unmet medical need that may improve CABG outcomes.
Hypotesis:
To assess the potential link between platelet function testing and bleeding risk in patients undergoing CABG.
Methods:
Platelet aggregation and clinical outcomes in 478 patients treated with aspirin and/or clopidogrel were retrospectively analyzed. Platelet activity was assessed prior to CABG with arachidonic acid (ASPI Test), and adenosine diphosphate(ADP Test) utilizing multiple-electrode aggregometry.
Results:
In the study group of 478 patients, mean age was 65.2±15.2 years; 138 were women. The majority of patients (n = 198) underwent on-pump surgery, with 162 undergoing off-pump and 30 undergoing minimally invasive surgery. Forty-eight patients received artificial valve implantation alone, and 40 received valve implantation in combination with CABG. The analysis of the entire pool revealed that an ASPI test value <407 area under curve per minute (AUC*min) may be useful in predicting postoperative drainage. In CABG patients only, an ASPI test value <271 AUC*min predicted the need for red blood cell concentrate transfusion following surgery. In patients who stopped clopidogrel for up to 5 days before surgery, the ADP test failed to exhibit prognostic utility for predicting bleeding risk.
Conclusions:
In patients undergoing heart surgery, an ASPI test value <407 AUC*min may predict higher postoperative drainage, whereas <271 AUC*min may be linked to postoperative use of red blood cell concentrate.
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