Kerry J Welsh1, Amitava Dasgupta1, Andy N D Nguyen1, Amer Wahed2. 1. Department of Pathology and Laboratory Medicine, University of Texas Medical School at Houston, Houston, TX, USA. 2. Department of Pathology and Laboratory Medicine, University of Texas Medical School at Houston, Houston, TX, USA Md.A.Wahed@uth.tmc.edu.
Abstract
BACKGROUND: Patients with cardiovascular disease are frequently on aspirin, which may place them at risk for bleeding during surgical procedures. The utility of the VerifyNow test to rapidly identify an aspirin effect and predict bleeding risk prior to cardiac surgery was explored. METHODS: A retrospective study was performed of patients on a clinical pathology consultation service that provides laboratory and transfusion support for patients undergoing major cardiac surgery. Patients who had VerifyNow testing for aspirin effect were selected. RESULTS: A total of 88 patients had VerifyNow aspirin testing during the study period. The VerifyNow test correctly identified 52/63 (82.5%) patients with documented aspirin use, and missed 11/63 (17.5%) of aspirin users. Light transmission aggregometry (LTA) showed an aspirin effect in the majority of aspirin users missed by the VerifyNow assay. Moderate correlations were found between LTA and VerifyNow. Low aspirin reaction units were not associated with significant bleeding in these cardiac surgery patients. CONCLUSIONS: We propose the VerifyNow assay for point-of-care identification of aspirin effect prior to emergency surgeries.
BACKGROUND:Patients with cardiovascular disease are frequently on aspirin, which may place them at risk for bleeding during surgical procedures. The utility of the VerifyNow test to rapidly identify an aspirin effect and predict bleeding risk prior to cardiac surgery was explored. METHODS: A retrospective study was performed of patients on a clinical pathology consultation service that provides laboratory and transfusion support for patients undergoing major cardiac surgery. Patients who had VerifyNow testing for aspirin effect were selected. RESULTS: A total of 88 patients had VerifyNow aspirin testing during the study period. The VerifyNow test correctly identified 52/63 (82.5%) patients with documented aspirin use, and missed 11/63 (17.5%) of aspirin users. Light transmission aggregometry (LTA) showed an aspirin effect in the majority of aspirin users missed by the VerifyNow assay. Moderate correlations were found between LTA and VerifyNow. Low aspirin reaction units were not associated with significant bleeding in these cardiac surgery patients. CONCLUSIONS: We propose the VerifyNow assay for point-of-care identification of aspirin effect prior to emergency surgeries.
Authors: Laura M Willemsen; Eline A Vlot; Paul W A Janssen; Claire D Visser; Kai Zheng; Johannes C Kelder; Peter G Noordzij; Erik-Jan van den Dool; Patrick Klein; Christian M Hackeng; Jurrien M Ten Berg Journal: Res Pract Thromb Haemost Date: 2021-12-27