Author + information
- Mohammad Urooj Zafar,
- Kevin Chen,
- Juan Rey-Mendoza,
- Carlos Linares Koloffon,
- Gustavo Jimenez,
- Gines Escolar,
- Valentin Fuster and
- Juan Badimon
Background: Patients on antiplatelet therapy requiring surgery must wait 5-7 day after ending therapy to minimize risk of bleeding. Platelet transfusion is often used to counter the antiplatelet actions but the optimal time for its use and the degree of functional recovery attained is not well-known. We explored the extent to which function could be restored using fresh platelets within 48 hours (hr) of stopping ticagrelor and the effect timing from last-dose has on the recovery.
Methods: After baseline testing of ADP-aggregation (Multiplate Analyzer), CVD patients (n=19, 57±8 years, 63% male, 75% T2DM) took daily ticagrelor plus aspirin for 1 week. At 6, 24 and 48 hr after the last dose, fresh platelets from healthy donors were added ex vivo to patients’ blood samples raising cell counts by 0% (no platelets added), 25% and 50%. Platelet function was then compared with pretreatment baseline.
Results: Platelet reactivity was progressively higher in 25% and 50% vs. 0% sample (p<0.05 for both) at each timepoint. Functional improvements with supplementation were statistically significant at 6 hr, but of potential clinical value only after 24 hr. At 48 hr reactivity in 25% and 50% samples was statistically no different from baseline (Fig 1).
Conclusions: Antiplatelet effects of ticagrelor can be reversed using fresh platelets in ex vivo testing, with substantial functional recovery attained 24 hr after stopping therapy and total recovery possible after 48 hours. The improvements show a dose and time dependent pattern.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Coronary Angiography, Intra-Vascular Imaging, Revascularization and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1166-322
- 2017 American College of Cardiology Foundation