Low platelet activity predicts 30 days mortality in patients undergoing heart surgery

Wiktor Kuliczkowski, Joanna Sliwka, Jacek Kaczmarski, Dorota Zysko, Michal Zembala, Dawid Steter, Marian Zembala, Marek Gierlotka, Moo Hyun Kim, Victor Serebruany

Research output: Contribution to journalArticle

Abstract

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 Retrospective analyses of platelet biomarkers and death at 30 days in 478 heart surgery patients withdrawn from aspirin or/and clopidogrel.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

Original languageEnglish (US)
Pages (from-to)199-204
Number of pages6
JournalBlood Coagulation and Fibrinolysis
Volume27
Issue number2
DOIs
StatePublished - Mar 1 2016

Fingerprint

Coronary Artery Bypass
Thoracic Surgery
Blood Platelets
clopidogrel
Mortality
Adenosine Diphosphate
Aspirin
Electric Impedance
Arachidonic Acid
Area Under Curve
Erythrocytes
Biomarkers
Survival

Keywords

  • aspirin
  • clopidogrel
  • heart surgery
  • mortality
  • platelet aggregation
  • prediction

ASJC Scopus subject areas

  • Hematology

Cite this

Kuliczkowski, W., Sliwka, J., Kaczmarski, J., Zysko, D., Zembala, M., Steter, D., ... Serebruany, V. (2016). Low platelet activity predicts 30 days mortality in patients undergoing heart surgery. Blood Coagulation and Fibrinolysis, 27(2), 199-204. https://doi.org/10.1097/MBC.0000000000000418

Low platelet activity predicts 30 days mortality in patients undergoing heart surgery. / Kuliczkowski, Wiktor; Sliwka, Joanna; Kaczmarski, Jacek; Zysko, Dorota; Zembala, Michal; Steter, Dawid; Zembala, Marian; Gierlotka, Marek; Kim, Moo Hyun; Serebruany, Victor.

In: Blood Coagulation and Fibrinolysis, Vol. 27, No. 2, 01.03.2016, p. 199-204.

Research output: Contribution to journalArticle

Kuliczkowski, W, Sliwka, J, Kaczmarski, J, Zysko, D, Zembala, M, Steter, D, Zembala, M, Gierlotka, M, Kim, MH & Serebruany, V 2016, 'Low platelet activity predicts 30 days mortality in patients undergoing heart surgery', Blood Coagulation and Fibrinolysis, vol. 27, no. 2, pp. 199-204. https://doi.org/10.1097/MBC.0000000000000418
Kuliczkowski, Wiktor ; Sliwka, Joanna ; Kaczmarski, Jacek ; Zysko, Dorota ; Zembala, Michal ; Steter, Dawid ; Zembala, Marian ; Gierlotka, Marek ; Kim, Moo Hyun ; Serebruany, Victor. / Low platelet activity predicts 30 days mortality in patients undergoing heart surgery. In: Blood Coagulation and Fibrinolysis. 2016 ; Vol. 27, No. 2. pp. 199-204.
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