title: Thrombin based gelatin matrix and fibrin sealant mediated clot formation in the presence of clopidogrel.
abstract: BACKGROUND
  Platelet inhibitors are commonly used to reduce the risk of atherothrombotic events. The aim of this study was to determine the impact of platelet inhibitors, specifically clopidogrel and aspirin, on clot kinetics, strength, and/or structure during the use of thrombin based gelatin matrices and fibrin sealants.
  
  
  METHODS
  Blood was collected and heparinized from donors on clopidogrel (and aspirin) and age matched control donors. Blood component analysis, whole blood platelet aggregometry, and activated clotting time (ACT) were used to monitor compliance to therapy and identify any differences between donor groups. Clot kinetics and strength were analyzed using thrombelastography (TEG). Field Emission Scanning Electron Microscopy (FESEM) was used to analyze clot structure.
  
  
  RESULTS
  Blood component profiles were similar for both donor groups. Aggregometry indicated that aggregation response to adenosine diphosphate (ADP) for clopidogrel donors was 12% of that for the controls (p = 0.0021), an expected result of clopidogrel induced platelet inhibition. However, blood from both donor groups had an elevated thrombin induced aggregation response. Heparinization of donor blood resulted in similarly elevated ACTs for both donor groups. TEG results indicated similar clot kinetics and strength between clopidogrel and control donor groups for blood alone and when clotting was induced using thrombin based gelatin matrices and fibrin sealants. FESEM images supported TEG findings in that similar morphologies were observed in ex vivo formed clots from both donor groups when thrombin based gelatin matrices and fibrin sealants were used.
  
  
  CONCLUSIONS
  These results suggest that platelet inhibitors do not negatively impact clot kinetics, strength, and structure when clotting is initiated with thrombin based gelatin matrices and fibrin sealants.
authors.affiliation: Baxter Healthcare Corporation, Deerfield, IL, USA.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Dwyer
authors.affiliation: Baxter Healthcare Corporation, Deerfield, IL, USA.
authors.forename: Jill A
authors.initials: JA
authors.lastname: McCoy
authors.affiliation: Baxter Healthcare Corporation, Deerfield, IL, USA.
authors.forename: Ziping
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Baxter Healthcare Corporation, Deerfield, IL, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Husser
authors.affiliation: Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Austrian Cluster for Tissue Regeneration, Vienna, Austria.
authors.forename: Heinz
authors.initials: H
authors.lastname: Redl
authors.affiliation: Baxter Healthcare Corporation, Deerfield, IL, USA.
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Murphy
authors.affiliation: Baxter Innovations GmbH, Wagramerstrasse 17-19, 1220 Wien, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Wolfsegger
authors.affiliation: Baxter Healthcare Corporation, Deerfield, IL, USA.
authors.forename: James P
authors.initials: JP
authors.lastname: DiOrio
authors.affiliation: Baxter Innovations GmbH, Wagramerstrasse 17-19, 1220 Wien, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Goppelt
authors.affiliation: Baxter Healthcare Corporation, Deerfield, IL, USA.
authors.forename: Shane
authors.initials: S
authors.lastname: Donovan
keywords: Clopidogrel; Floseal; Hemostasis; Thrombelastography; Thrombin; Tisseel