Author + information
- Mohammad Urooj Zafar,
- Donald Smith,
- Usman Baber,
- Samantha Sartori,
- Gines Escolar,
- Valentin Fuster and
- Juan Badimon
Background: ACC/AHA guidelines advise waiting 5 days before operating on ticagrelor treated patients so its antiplatelet effects can wear off. Platelet transfusion is often used to reduce bleeding risk but the effect of transfusion-timing on the degree of functional recovery attained is not well-established. We investigated the earliest time after ticagrelor loading when adding fresh platelets could restore patients’ platelet function to near pre-treatment levels.
Methods: Platelet reactivity (ADP-aggregation using Multiplate Analyzer) of CVD patients (n=19, 57±8 years, 63% male, 75% diabetic) was measured before (Baseline) administering ticagrelor 180 mg and aspirin 325 mg. At 6, 24 and 48 hours post-dosing, platelet concentrates from healthy donors were added ex vivo to patients’ blood samples raising platelet counts by 0% (no platelets added), 25% and 50%. Platelet reactivity was then compared with Baseline and respective 0% sample.
Results: Platelet reactivity was higher in 25% and 50% vs. 0% sample (p<0.05 for both) at each time-point. Substantial increases in reactivity were observed starting at 24 hours. At 48 hours function in supplemented samples were statistically no different from baseline (Figure 1).
Conclusions: Platelet supplementation counteracts the inhibitory effects of ticagrelor in a dose and time dependent manner. Sizeable improvements in ex vivo platelet function are evident 24 hours after ticagrelor loading, with restoration to baseline possible after 48-hours.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Antiplatelet and Antithrombotic Agents in Ischemic Heart Disease
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1296-304
- 2017 American College of Cardiology Foundation