Related Experiment Video
Updated: Mar 6, 2026
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Relationship between thromboelastography and long-term ischemic events as gauged by the response to clopidogrel in
Xumin Hou1, Wenzheng Han1, Qian Gan1
1Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University.
Insights
Thromboelastography (TEG) effectively measures platelet function after percutaneous coronary intervention (PCI). This technique helps predict ischemic events, improving risk stratification and guiding antiplatelet therapy for coronary heart disease (CHD) patients.
Area of Science:
- Cardiology
- Hematology
- Medical Technology
Background:
- Ischemic events are a significant risk for patients with coronary heart disease (CHD) following percutaneous coronary intervention (PCI).
- Optimizing antiplatelet therapy is crucial for managing these risks, but individual patient responses can vary.
- Accurate measurement of platelet function is needed for better risk stratification and personalized treatment.
Purpose of the Study:
- To evaluate thromboelastography (TEG) as a method for assessing platelet function in vitro.
- To determine the diagnostic and prognostic utility of maximum amplitude of adenosine diphosphate induced platelet-fibrin clots (MAADP) measured by TEG.
- To investigate if TEG can improve risk stratification and guide antiplatelet therapy in patients undergoing elective PCI.
Main Methods:
- TEG was used to measure MAADP in 759 patients undergoing elective PCI.
- Patients received clopidogrel pretreatment and maintenance doses of aspirin and clopidogrel.
- Platelet-fibrin clot strength was assessed, and MAADP values were correlated with ischemic events.
Main Results:
- An MAADP > 34 mm significantly predicted ischemic events after PCI (AUC = 0.79, P < 0.05).
- Multivariate analysis identified MAADP > 34 mm and fasting blood glucose (FBG) > 7.0 mmol/L as independent predictors of ischemic events at 2 years.
- TEG demonstrated utility in diagnosing potential ischemic events based on MAADP levels in patients pretreated with clopidogrel.
Conclusions:
- TEG is a valuable tool for measuring platelet function in patients undergoing elective PCI.
- MAADP measured by TEG can aid in predicting ischemic events and personalizing antiplatelet therapy.
- This approach offers improved risk stratification for coronary heart disease patients post-PCI.
Abstract:
Ischemic events after percutaneous coronary intervention (PCI) remain a major concern for patients with coronary heart disease (CHD). The aim of the current study was to investigate whether thromboelastography (TEG) was a satisfactory technique to measure platelet function in vitro in order to improve risk stratification and the individual response to antiplatelet therapy. The diagnostic and prognostic utility of the maximum amplitude of adenosine diphosphate induced platelet-fibrin clots (MAADP) was measured with TEG in 759 patients undergoing elective PCI. A 600-mg dose of clopidogrel was taken more than 12 h before surgery in addition to a maintenance dose of aspirin 100 mg/day and clopidogrel 75 mg/day for 2 y. Platelet-fibrin clot strength was also measured in this study. An MAADP > 34 mm significantly predicted ischemic events after PCI, as indicated by an area under the curve (AUC) of 0.79 (95% CI: 0.72-0.87, P < 0.05) according to receiver operating characteristic (ROC) curve analysis. The multivariate Cox proportional hazards model identified MAADP > 34 mm and an FBG level > 7.0 mmol/L as significant independent predictors of first ischemic events at the 2-year time point (P < 0.05). With adequate clopidogrel pretreatment, patients who underwent elective PCI and who experienced ischemic events could be diagnosed with a certain MAADP according to TEG. TEG could be a good tool to measure platelet function.
Related Concept Videos
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
01:30Acute Coronary Syndrome III: Diagnostic Studies