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Monitoring of Antiplatelet Therapy in Children on Ventricular Assist Device Support: Comparison of Multiplate and Thromboelastography Platelet Mapping

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Monitoring of Antiplatelet Therapy in Children on Ventricular Assist Device Support : Comparison of Multiplate and Thromboelastography Platelet Mapping. / Ferguson, Lee P.; Duong, Phuoc; Pearce, Kim F.; Murphy, Paul; Biss, Tina T.

In: Asaio Journal, Vol. 65, No. 1, 01.01.2019, p. 84-93.

Research output: Contribution to journalArticle

Harvard

Ferguson, LP, Duong, P, Pearce, KF, Murphy, P & Biss, TT 2019, 'Monitoring of Antiplatelet Therapy in Children on Ventricular Assist Device Support: Comparison of Multiplate and Thromboelastography Platelet Mapping', Asaio Journal, vol. 65, no. 1, pp. 84-93. https://doi.org/10.1097/MAT.0000000000000768

APA

Ferguson, L. P., Duong, P., Pearce, K. F., Murphy, P., & Biss, T. T. (2019). Monitoring of Antiplatelet Therapy in Children on Ventricular Assist Device Support: Comparison of Multiplate and Thromboelastography Platelet Mapping. Asaio Journal, 65(1), 84-93. https://doi.org/10.1097/MAT.0000000000000768

Vancouver

Ferguson LP, Duong P, Pearce KF, Murphy P, Biss TT. Monitoring of Antiplatelet Therapy in Children on Ventricular Assist Device Support: Comparison of Multiplate and Thromboelastography Platelet Mapping. Asaio Journal. 2019 Jan 1;65(1):84-93. https://doi.org/10.1097/MAT.0000000000000768

Author

Ferguson, Lee P. ; Duong, Phuoc ; Pearce, Kim F. ; Murphy, Paul ; Biss, Tina T. / Monitoring of Antiplatelet Therapy in Children on Ventricular Assist Device Support : Comparison of Multiplate and Thromboelastography Platelet Mapping. In: Asaio Journal. 2019 ; Vol. 65, No. 1. pp. 84-93.

Bibtex Download

@article{79c641b53ccb4f2db1ebc5dc45ad4f00,
title = "Monitoring of Antiplatelet Therapy in Children on Ventricular Assist Device Support: Comparison of Multiplate and Thromboelastography Platelet Mapping",
abstract = "The optimal method for monitoring antiplatelet therapy in children supported with ventricular assist devices (VADs) is unknown. We conducted a retrospective study to compare Thromboelastography Platelet Mapping (TEG/PM) with multiple electrode platelet aggregometry (MEA) on a Multiplate analyzer (Roche Diagnostics, Mannheim, Germany). We analyzed data from 66 paired blood samples from 9 patients <16 years of age on VAD where platelet function was simultaneously measured with TEG/PM and MEA. Antiplatelet dose–response relationships and intraindividual variability during steady state therapy were determined. Agreement in determination of therapeutic antiplatelet therapy was poor (arachidonic acid, κ 0.23; adenosine diphosphate [ADP], κ 0.13). Rate of aspirin and clopidogrel resistance was much higher when determined using TEG/PM than MEA. In patients receiving ≥5 mg/kg/day aspirin, 72{\%} of TEG/PM measurements showed subtherapeutic response compared with 11{\%} of MEA measurements. There was evidence of a dose–response relationship with clopidogrel and MEA ADP-induced aggregation (R 2 = 0.56; p < 0.0001); however, there was no association between dose and TEG/PM{\%} ADP inhibition (p = 0.15). Intraindividual variability in platelet reactivity was far greater when measured by TEG/PM during steady state therapy. Multiple electrode platelet aggregometry appears to be more reliable than TEG/PM for monitoring antiplatelet therapy in children supported with VAD.",
keywords = "heart failure, heart-assist device, pediatrics, platelet aggregation inhibitors, platelet function tests, thrombosis",
author = "Ferguson, {Lee P.} and Phuoc Duong and Pearce, {Kim F.} and Paul Murphy and Biss, {Tina T.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1097/MAT.0000000000000768",
language = "English",
volume = "65",
pages = "84--93",
journal = "Asaio Journal",
issn = "1058-2916",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Monitoring of Antiplatelet Therapy in Children on Ventricular Assist Device Support

T2 - Comparison of Multiplate and Thromboelastography Platelet Mapping

AU - Ferguson, Lee P.

AU - Duong, Phuoc

AU - Pearce, Kim F.

AU - Murphy, Paul

AU - Biss, Tina T.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - The optimal method for monitoring antiplatelet therapy in children supported with ventricular assist devices (VADs) is unknown. We conducted a retrospective study to compare Thromboelastography Platelet Mapping (TEG/PM) with multiple electrode platelet aggregometry (MEA) on a Multiplate analyzer (Roche Diagnostics, Mannheim, Germany). We analyzed data from 66 paired blood samples from 9 patients <16 years of age on VAD where platelet function was simultaneously measured with TEG/PM and MEA. Antiplatelet dose–response relationships and intraindividual variability during steady state therapy were determined. Agreement in determination of therapeutic antiplatelet therapy was poor (arachidonic acid, κ 0.23; adenosine diphosphate [ADP], κ 0.13). Rate of aspirin and clopidogrel resistance was much higher when determined using TEG/PM than MEA. In patients receiving ≥5 mg/kg/day aspirin, 72% of TEG/PM measurements showed subtherapeutic response compared with 11% of MEA measurements. There was evidence of a dose–response relationship with clopidogrel and MEA ADP-induced aggregation (R 2 = 0.56; p < 0.0001); however, there was no association between dose and TEG/PM% ADP inhibition (p = 0.15). Intraindividual variability in platelet reactivity was far greater when measured by TEG/PM during steady state therapy. Multiple electrode platelet aggregometry appears to be more reliable than TEG/PM for monitoring antiplatelet therapy in children supported with VAD.

AB - The optimal method for monitoring antiplatelet therapy in children supported with ventricular assist devices (VADs) is unknown. We conducted a retrospective study to compare Thromboelastography Platelet Mapping (TEG/PM) with multiple electrode platelet aggregometry (MEA) on a Multiplate analyzer (Roche Diagnostics, Mannheim, Germany). We analyzed data from 66 paired blood samples from 9 patients <16 years of age on VAD where platelet function was simultaneously measured with TEG/PM and MEA. Antiplatelet dose–response relationships and intraindividual variability during steady state therapy were determined. Agreement in determination of therapeutic antiplatelet therapy was poor (arachidonic acid, κ 0.23; adenosine diphosphate [ADP], κ 0.13). Rate of aspirin and clopidogrel resistance was much higher when determined using TEG/PM than MEA. In patients receiving ≥5 mg/kg/day aspirin, 72% of TEG/PM measurements showed subtherapeutic response compared with 11% of MEA measurements. There was evidence of a dose–response relationship with clopidogrel and MEA ADP-induced aggregation (R 2 = 0.56; p < 0.0001); however, there was no association between dose and TEG/PM% ADP inhibition (p = 0.15). Intraindividual variability in platelet reactivity was far greater when measured by TEG/PM during steady state therapy. Multiple electrode platelet aggregometry appears to be more reliable than TEG/PM for monitoring antiplatelet therapy in children supported with VAD.

KW - heart failure

KW - heart-assist device

KW - pediatrics

KW - platelet aggregation inhibitors

KW - platelet function tests

KW - thrombosis

UR - http://www.scopus.com/inward/record.url?scp=85059228146&partnerID=8YFLogxK

U2 - 10.1097/MAT.0000000000000768

DO - 10.1097/MAT.0000000000000768

M3 - Article

VL - 65

SP - 84

EP - 93

JO - Asaio Journal

JF - Asaio Journal

SN - 1058-2916

IS - 1

ER -

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