TY - JOUR
T1 - Low platelet activity predicts 30 days mortality in patients undergoing heart surgery
AU - Kuliczkowski, Wiktor
AU - Sliwka, Joanna
AU - Kaczmarski, Jacek
AU - Zysko, Dorota
AU - Zembala, Michal
AU - Steter, Dawid
AU - Zembala, Marian
AU - Gierlotka, Marek
AU - Kim, Moo Hyun
AU - Serebruany, Victor
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Despite advanced techniques and improved clinical outcomes, patient survival following coronary artery bypass grafting (CABG) is still a major concern. Therefore, predicting future CABG mortality represents an unmet medical need and should be carefully explored. The objective of this study is to assess whether pre-CABG platelet activity corresponds with 30 days mortality post-CABG. Retrospective analyses of platelet biomarkers and death at 30 days in 478 heart surgery patients withdrawn from aspirin or/and clopidogrel. Platelet activity was assessed prior to CABG for aspirin (ASPI-test) with arachidonic acid and clopidogrel (ADP-test) utilizing Multiplate impedance aggregometer. Most patients (n=198) underwent conventional CABG, off-pump (n=162), minimally invasive (n=30), artificial valve implantation (n=48) or valves in combination with CABG (n=40). There were 22 deaths at 30 days, including 10 in-hospital fatalities. With the cut-off value set below 407 area under curve (AUC) for the ASPI-test, the 30-day mortality was 5.90% for the lower cohort and 2.66% for patients with significantly higher platelet reactivity (P=0.038). For the ADP-test with a cut-off at 400AUC, the 30-day mortality was 9.68% for the lower cohort and 3.66% for patients with higher platelet reactivity, representing a borderline significant difference (P=0.046). Aside from the platelet indices, patients who received red blood cell (RBC) concentrate had a highly significant (P
AB - Despite advanced techniques and improved clinical outcomes, patient survival following coronary artery bypass grafting (CABG) is still a major concern. Therefore, predicting future CABG mortality represents an unmet medical need and should be carefully explored. The objective of this study is to assess whether pre-CABG platelet activity corresponds with 30 days mortality post-CABG. Retrospective analyses of platelet biomarkers and death at 30 days in 478 heart surgery patients withdrawn from aspirin or/and clopidogrel. Platelet activity was assessed prior to CABG for aspirin (ASPI-test) with arachidonic acid and clopidogrel (ADP-test) utilizing Multiplate impedance aggregometer. Most patients (n=198) underwent conventional CABG, off-pump (n=162), minimally invasive (n=30), artificial valve implantation (n=48) or valves in combination with CABG (n=40). There were 22 deaths at 30 days, including 10 in-hospital fatalities. With the cut-off value set below 407 area under curve (AUC) for the ASPI-test, the 30-day mortality was 5.90% for the lower cohort and 2.66% for patients with significantly higher platelet reactivity (P=0.038). For the ADP-test with a cut-off at 400AUC, the 30-day mortality was 9.68% for the lower cohort and 3.66% for patients with higher platelet reactivity, representing a borderline significant difference (P=0.046). Aside from the platelet indices, patients who received red blood cell (RBC) concentrate had a highly significant (P
KW - aspirin
KW - clopidogrel
KW - heart surgery
KW - mortality
KW - platelet aggregation
KW - prediction
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U2 - 10.1097/MBC.0000000000000418
DO - 10.1097/MBC.0000000000000418
M3 - Article
C2 - 26366827
AN - SCOPUS:84957427412
SN - 0957-5235
VL - 27
SP - 199
EP - 204
JO - Blood Coagulation and Fibrinolysis
JF - Blood Coagulation and Fibrinolysis
IS - 2
ER -