A Comparative Study of Multiple Electrode Aggregometry Technologies in Cardiac Surgery: Different Values, Same...

Area of Science:

• Cardiology
• Hematology
• Medical Devices

Background:

• Assessing platelet function is crucial in cardiac surgery patients on dual-antiplatelet therapy.
• Multiplate (MP) and ROTEM Platelet (RP) are electrical impedance-based devices used for platelet function assessment.
• Guidelines address platelet function assessment, but device agreement requires clarification.

Purpose of the Study:

• To determine the agreement between MP and RP in assessing platelet function in cardiac surgery patients discontinuing dual-antiplatelet therapy before surgery.
• To compare the predictive ability of MP and RP for postoperative bleeding and platelet transfusion needs.

Main Methods:

• A prospective cohort study involving 50 adult cardiac surgery patients.
• Preoperative and postoperative platelet function testing using adenosine diphosphate (ADP) and thrombin receptor-activating peptide (TRAP) on both MP and RP devices.
• Analysis of agreement between MP and RP, and their correlation with postoperative bleeding and transfusion requirements.

Main Results:

• Preoperative ADP tests indicated residual antiplatelet effects, with mean values below reference limits.
• Agreement between MP and RP was very poor for both ADP and TRAP tests (80% error).
• Preoperative ADP tests predicted the need for platelet concentrate transfusion (cut-off values: 35 U for ADP-MP, 60 Ω/min for ADP-RP), but did not correlate with postoperative bleeding.

Conclusions:

• MP and RP technologies show potential benefits for patients on antiplatelet drugs undergoing surgery.
• The results from MP and RP tests are not interchangeable.
• Different cut-off values must be applied for each device when interpreting results in this patient population.