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Association of Impedance Aggregometry-Measured Platelet Aggregation With Thromboembolic Events in Patients Who Undergo Carotid Endarterectomy: A Pilot Study.
Monaco, Fabrizio; Licheri, Margherita; Labanca, Rosa; Russetti, Federica; Oriani, Alessandro; Melissano, Germano; Chiesa, Roberto; Barucco, Gaia.
Afiliação
  • Monaco F; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy. Electronic address: monaco.fabrizio@hsr.it.
  • Licheri M; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Labanca R; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Russetti F; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Oriani A; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Melissano G; Department of Vascular Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
  • Chiesa R; Department of Vascular Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
  • Barucco G; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
J Cardiothorac Vasc Anesth ; 38(3): 771-779, 2024 Mar.
Article em En | MEDLINE | ID: mdl-38320918
ABSTRACT

OBJECTIVES:

The aim of the current study was to assess the relationship among thrombin receptor activator peptide 6 (TRAP test), adenosine-5'-diphosphate (ADP test), arachidonic acid (ASPI test), and stroke/transient ischemic attack (TIA), using the multiple electrode aggregometry (Multiplate) in patients undergoing carotid thromboendarterectomy (CEA).

DESIGN:

A retrospective study.

SETTING:

Vascular surgery operating rooms of a university hospital.

PARTICIPANTS:

One hundred thirty-one out of 474 patients undergoing CEA between November 2020 and October 2022.

INTERVENTIONS:

None. MEASUREMENTS AND MAIN

RESULTS:

A preoperative blood sample of all enrolled patients was analyzed using the Multiplate analyzer. Receiver operating characteristics curves, were generated to test the ability of TRAP, ADP, and ASPI in discriminating perioperative thromboembolic stroke/TIA. A logistic LASSO regression model was used to identify factors independently associated with stroke/TIA. Eight patients experienced a perioperative stroke/TIA. Although all the platelet functional assays showed excellent predictive performance, an ADP value exceeding 72 U showed the highest specificity (87%) and sensitivity (68%) in discriminating patients who had a perioperative thromboembolic stroke/TIA, with a negative predictive value of 99% and a positive predictive value of 15%. After LASSO regression, an ADP >72 U and the need for a shunt during CEA were the only 2 variables independently associated with perioperative stroke/TIA.

CONCLUSION:

Because the ADP test was independently associated with perioperative stroke/TIA, the assessment of platelet reactivity using Multiplate may offer potential utility in monitoring patients undergoing CEA.
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Texto completo: 1 Coleções: 01-internacional Temas: Geral Base de dados: MEDLINE Assunto principal: Tromboembolia / Ataque Isquêmico Transitório / Endarterectomia das Carótidas / Acidente Vascular Cerebral Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: J Cardiothorac Vasc Anesth Assunto da revista: ANESTESIOLOGIA / CARDIOLOGIA Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Temas: Geral Base de dados: MEDLINE Assunto principal: Tromboembolia / Ataque Isquêmico Transitório / Endarterectomia das Carótidas / Acidente Vascular Cerebral Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: J Cardiothorac Vasc Anesth Assunto da revista: ANESTESIOLOGIA / CARDIOLOGIA Ano de publicação: 2024 Tipo de documento: Article