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Microfluidics in Assessing Platelet Function
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Platelet function, coagulation and fibrinolysis in patients with previous coronary and cerebrovascular ischemic

Carlos José Dornas Gonçalves Barbosa1,2, Renata de Souza Barreiros1, André Franci1

  • 1Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.

Clinics (Sao Paulo, Brazil)
|October 3, 2019
PubMed

Insights

Patients with coronary artery disease and a history of stroke or TIA have similar platelet function and clotting compared to those without. Further research is needed to understand their elevated bleeding risk.

Area of Science:

  • Cardiology
  • Neurology
  • Hematology

Background:

  • Coronary artery disease (CAD) patients with a history of ischemic stroke (IS) or transient ischemic attack (TIA) represent a high-risk subgroup.
  • This population faces increased risks for both thrombotic and bleeding complications.

Purpose of the Study:

  • To investigate the role of platelet aggregability, coagulation, and endogenous fibrinolysis in CAD patients with a history of IS/TIA.
  • To identify potential mechanisms contributing to the heightened bleeding risk in this patient cohort.

Main Methods:

  • A prospective case-control study involving 140 stable CAD patients, divided into a CASE group (previous IS/TIA, n=70) and a CONTROL group (no previous IS/TIA, n=70).
  • Evaluated platelet aggregability (VerifyNow Aspirin®, VerifyNow P2Y12®), coagulation parameters (fibrinogen, thromboelastography), and fibrinolysis markers (D-dimer, plasminogen activator inhibitor-1).

Main Results:

  • The CASE group exhibited higher systolic blood pressure, more prior coronary artery bypass grafting (CABG), and increased calcium channel blocker use.
  • Adjusted models revealed associations between previous IS/TIA and lower triglycerides, lower hemoglobin, and higher systolic blood pressure.
  • Crucially, platelet aggregability, coagulation, and fibrinolysis tests were not independently linked to prior cerebrovascular ischemic events.

Conclusions:

  • Platelet aggregability, coagulation, and endogenous fibrinolysis do not differ significantly between CAD patients with and without a history of IS/TIA.
  • Additional factors must be explored to elucidate the underlying causes of the elevated bleeding risk in this vulnerable patient group.
Abstract

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