A comparison of Plateletworks and platelet aggregometry for the assessment of aspirin-related platelet dysfunction in cardiac surgical patients.
OBJECTIVE
To compare the assessment of aspirin-related platelet dysfunction using Plateletworks (Helena Laboratories, Beaumont, TX), a new point-of-care platelet function analyzer, with turbidometric platelet aggregometry, in cardiac surgical patients.


METHODS
Prospective observational study.


METHODS
University-affiliated teaching hospital.


METHODS
Fifty consecutive adult patients undergoing elective cardiac surgery for coronary artery bypass grafting or cardiac valve replacement.


METHODS
None.


RESULTS
Platelet function was assessed by Plateletworks and turbidometric platelet aggregometry before the commencement of anesthesia. Collagen, 10 microg/mL, was used as the agonist for both techniques. The area under the receiver-operator curve for the identification of recent aspirin ingestion (<or=48 hours v >or=72 hours) using Plateletworks was 0.58 (95% confidence interval [CI] 0.42-0.75) versus 0.77 (95% CI 0.61-0.95) for turbidometric platelet aggregometry. The Spearman correlation coefficient (rho) between preoperative Plateletworks trade mark and postoperative mediastinal blood loss was 0.07 (p = 0.58), and between preoperative turbidometric platelet aggregometry and postoperative mediastinal blood loss was -0.31 (p = 0.03). On completion of surgery, the correlation coefficients were 0.14 (p = 0.34) and -0.29 (p = 0.08), respectively.


CONCLUSIONS
These findings suggest that Plateletworks is of limited use for the detection of aspirin-related platelet defects in cardiac surgical patients.
Lennon
Mark J
MJ
Department of Anaesthesis, Sir Charles Gairdner Hospital, Nedlands, Australia.
Gibbs
Neville M
NM
Weightman
William M
WM
McGuire
David
D
Michalopoulos
Nick
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000009:adverse effects*; D001792:Blood Platelets / Q000187:drug effects*; D006348:Cardiac Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009391:Nephelometry and Turbidimetry / Q000379:methods; D010974:Platelet Aggregation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D010979:Platelet Function Tests / Q000379:methods*; D019106:Postoperative Hemorrhage / Q000097:blood; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013997:Time Factors
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin