Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Mahla, E; Suarez, TA; Bliden, KP; Rehak, P; Metzler, H; Sequeira, AJ; Cho, P; Sell, J; Fan, J; Antonino, MJ; Tantry, US; Gurbel, PA.
Platelet function measurement-based strategy to reduce bleeding and waiting time in clopidogrel-treated patients undergoing coronary artery bypass graft surgery: the timing based on platelet function strategy to reduce clopidogrel-associated bleeding related to CABG (TARGET-CABG) study.
Circ Cardiovasc Interv. 2012; 5(2):261-269
Doi: 10.1161/CIRCINTERVENTIONS.111.967208
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- Leading authors Med Uni Graz
- Mahla Elisabeth
- Co-authors Med Uni Graz
- Metzler Helfried
- Rehak Peter
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- Abstract:
- Background-Aspirin and clopidogrel therapy is associated with a variable bleeding risk in patients undergoing coronary artery bypass graft surgery (CABG). We evaluated the role of platelet function testing in clopidogrel-treated patients undergoing CABG. Methods and Results-One hundred eighty patients on background aspirin with/without clopidogrel therapy undergoing elective first time isolated on-pump CABG were enrolled in a prospective single-center, nonrandomized, unblinded investigation (Timing Based on Platelet Function Strategy to Reduce Clopidogrel-Associated Bleeding Related to CABG [TARGET-CABG] study) between September 2008 and January 2011. Clopidogrel responsiveness (ADP-induced platelet-fibrin clot strength [MAADP]) was determined by thrombelastography; CABG was done within 1 day, 3-5 days, and ANDgt; 5 days in patients with an MA(ADP) ANDgt; 50 mm, 35-50 mm, and ANDlt; 35 mm, respectively. The primary end point was 24-hour chest tube drainage and key secondary end point was total number of transfused red blood cells. Equivalence was defined as ANDlt;= 25% difference between groups. ANCOVA was used to adjust for confounders. Mean 24-hour chest tube drainage in clopidogrel-treated patients was 93% (95% confidence interval, 81-107%) of the amount observed in clopidogrel-naive patients, and the total amount of red blood cells transfused did not differ between groups (1.80 U versus 2.08 U, respectively, P=0.540). The total waiting period in clopidogrel-treated patients was 233 days (mean, 2.7 days per patient). Conclusions-A strategy based on preoperative platelet function testing to determine the timing of CABG in clopidogrel-treated patients was associated with the same amount of bleeding observed in clopidogrel-naive patients and approximate to 50% shorter waiting time than recommended in the current guidelines. Clinical Trial Registration-URL: http://www.clinicaltrials.gov.Unique identifier: NCT00857155. (Circ Cardiovasc Interv. 2012;5:261-269.)
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Blood Transfusion - statistics & numerical data
- Chest Tubes -
- Coronary Artery Bypass -
- Drainage - statistics & numerical data
- Female -
- Humans -
- Male -
- Middle Aged -
- Platelet Function Tests -
- Postoperative Hemorrhage - diagnosis
- Practice Guidelines as Topic -
- Preoperative Care -
- Thrombelastography -
- Ticlopidine - analogs & derivatives
- Watchful Waiting - methods
- Find related publications in this database (Keywords)
- cardiopulmonary bypass
- antiplatelet therapy
- bleeding