title: The use of platelet reactivity testing in patients on antiplatelet therapy for prediction of bleeding events after cardiac surgery.
abstract: Many patients are treated with platelet inhibitors such as aspirin and clopidogrel for prevention of thrombotic cardiovascular events. However, the inhibitory effect of antiplatelet therapy is variable between patients; in some, the platelets are hardly inhibited, while in others, the platelets are excessively inhibited. The newer and more potent platelet inhibitors, prasugrel and ticagrelor, often lead to low platelet reactivity, which potentially leads to bleeding events. Preoperative measurement of platelet reactivity in patients receiving platelet inhibitors who undergo cardiac surgery, could be useful to identify those with low platelet reactivity and thus have an increased risk of bleeding during or after surgery. In this review, we discuss the most commonly used platelet inhibitors and platelet function tests. Furthermore, we will provide an overview of the evidence for the prediction of post-operative bleeding at the operation site with preoperative platelet reactivity testing in patients undergoing cardiac surgery.
authors.affiliation: Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Heidelberglaan, 100, 3584 CX Utrecht, The Netherlands; Department of Vascular Surgery, University Medical Center Utrecht, Heidelberglaan, 100, 3584 CX Utrecht, The Netherlands. Electronic address: T.C.Leunissen@umcutrecht.nl.
authors.forename: Tesse C
authors.initials: TC
authors.lastname: Leunissen
authors.affiliation: Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands; St Antonius Center for Platelet Function Research, St Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands.
authors.forename: Paul W A
authors.initials: PW
authors.lastname: Janssen
authors.affiliation: Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands; St Antonius Center for Platelet Function Research, St Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands.
authors.forename: Jurriën M
authors.initials: JM
authors.lastname: Ten Berg
authors.affiliation: Department of Vascular Surgery, University Medical Center Utrecht, Heidelberglaan, 100, 3584 CX Utrecht, The Netherlands.
authors.forename: Frans L
authors.initials: FL
authors.lastname: Moll
authors.affiliation: Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Heidelberglaan, 100, 3584 CX Utrecht, The Netherlands.
authors.forename: Suzanne J A
authors.initials: SJ
authors.lastname: Korporaal
authors.affiliation: Department of Vascular Surgery, University Medical Center Utrecht, Heidelberglaan, 100, 3584 CX Utrecht, The Netherlands.
authors.forename: Gert Jan
authors.initials: GJ
authors.lastname: de Borst
authors.affiliation: Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Heidelberglaan, 100, 3584 CX Utrecht, The Netherlands; Department of Experimental Cardiology, University Medical Center Utrecht, Heidelberglaan, 100, 3584 CX Utrecht, The Netherlands.
authors.forename: Gerard
authors.initials: G
authors.lastname: Pasterkamp
authors.affiliation: Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Heidelberglaan, 100, 3584 CX Utrecht, The Netherlands.
authors.forename: Rolf T
authors.initials: RT
authors.lastname: Urbanus
mesh_terms: D001792:Blood Platelets / Q000187:drug effects* / Q000502:physiology; D006348:Cardiac Surgical Procedures; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D015539:Platelet Activation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D010979:Platelet Function Tests; D011237:Predictive Value of Tests
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Bleeding complications; Cardiac surgery; Coronary artery bypass graft; P2Y(12) inhibitors; Platelet inhibitors; Platelet reactivity testing