Evaluation of platelet function using PFA-100® in patients treated with Acetylsalicylic acid and qualified for Trauma and Orthopedic surgery procedures.
The phenomenon of high on-acetylsalicylic acid (ASA) treatment platelet (PLT) reactivity - HATPR - and its clinical implications have not been fully understood. Little data is available on assessing PLT activity based on the severity of intra- and postoperative bleeding in a population of orthopedic patients with normal closure time (CT) measured by a PLT function analyzer PFA-100®, despite being given long-term ASA therapy. The aim is to assess PLT function using PFA-100® in patients with ASA therapy and qualified for trauma and orthopedic surgery procedures. The retrospective analysis covered 384 patients whose PLT reactivity was assessed using PFA-100®. Out of those, 198 had been taking ASA with a 75 mg dose until hospital admission. In addition, a group of 70 patients with a proximal femoral fracture surgically treated using the dynamic hip screw (DHS) was selected, in whom severity of bleeding was assessed by HIP ASA (+). The reference group comprised 52 patients (without ASA therapy) who were operated on due to the same indications. Normal CT was found in 37% of ASA-receiving patients. Patients with normal CT, despite ASA therapy, exhibited significantly more intense bleeding after DHS surgery. A similar number of patients required red blood cells (RBCs) transfusion in HIP ASA (+) and HIP ASA (-). Increased risk of complications in HIP ASA (+) group was not found.


CONCLUSIONS
Normal PLT function assessed using PFA-100® is a common phenomenon in patients with long-term ASA treatment and who are qualified for trauma and orthopedic surgery procedures. In many cases, it seems that inadequate response to ASA is only a laboratory phenomenon.
a Department of Trauma and Orthopaedics , District Trauma and Orthopaedic Hospital , Piekary Sląskie , Poland.
J
J
Kurak
a Department of Trauma and Orthopaedics , District Trauma and Orthopaedic Hospital , Piekary Sląskie , Poland.
P
P
Zając
b Department of Thoracic Surgery, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland.
D
D
Czyżewski
a Department of Trauma and Orthopaedics , District Trauma and Orthopaedic Hospital , Piekary Sląskie , Poland.
R
R
Kucharski
c Department of Internal Diseases, Dermatology and Allergology in Zabrze, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland.
R
R
Grzanka
c Department of Internal Diseases, Dermatology and Allergology in Zabrze, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland.
A
A
Kasperska-Zajac
a Department of Trauma and Orthopaedics , District Trauma and Orthopaedic Hospital , Piekary Sląskie , Poland.
B
B
Koczy
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000494:pharmacology* / Q000627:therapeutic use; D001780:Blood Coagulation Tests; D001792:Blood Platelets / Q000187:drug effects* / Q000378:metabolism*; D000066491:Clinical Decision-Making; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D010979:Platelet Function Tests / Q000379:methods* / Q000592:standards; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D014947:Wounds and Injuries / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D055815:Young Adult
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin
PFA-100®; aspirin resistance; high on-acetylsalicylic acid treatment platelet reactivity; platelet; trauma and orthopedic surgery procedures