Key result
Preoperative PFA-200 closure time >106 seconds independently predicted postoperative blood transfusion in patients undergoing elective cardiac surgery (OR 4.05; 95% CI 1.19-13.86; P=0.026).
Why the study?
The role of platelet function testing in the timing of cardiac surgery remains uncertain, and data correlating Platelet Function Analyzer 200 (PFA-200) with bleeding after elective cardiac surgery are inadequate.
Does elevated preoperative Platelet Function Analyzer 200 (PFA-200) closure time predict postoperative blood transfusion in patients on dual antiplatelet therapy undergoing elective cardiac surgery?
Observational (n=71)
No
Does elevated preoperative Platelet Function Analyzer 200 (PFA-200) closure time predict postoperative blood transfusion in patients on dual antiplatelet therapy undergoing elective cardiac surgery?
Odds Ratio: 4.05 (95% CI 1.19–13.86)
Absolute Event Rate: 41.9% vs 14.7%
p-value: p=0.026
Preoperative assessment of platelet function using PFA-200 can independently predict the need for postoperative blood transfusion, offering a potential tool to optimize the timing of elective cardiac surgery in patients recently on dual antiplatelet therapy.
PFA-200 CT >106 s identifies higher transfusion risk on DAPT before cardiac surgery; hypothesis-generating and should not yet change practice.
The value of platelet function test in timing of cardiac surgery remains uncertain. Researches on correlation between Platelet Function Analyzer 200 (PFA-200) and bleeding after elective cardiac surgery are still inadequate. The objective of this study was to investigate the predictive value of PFA-200 in blood transfusion after cardiac surgery. A total of 71 patients on aspirin and P2Y12 receptor inhibitors undergoing cardiac surgery in Fuwai Hospital were enrolled. Platelet function after discontinuing of antiplatelet drugs was assessed by PFA-200 using closure time (CT). PFA-200 results before surgery were included in the statistics. The primary endpoint was postoperative blood transfusion. Seventeen patients (21.9%) received blood transfusion after cardiac surgery. The preoperative PFA-200 CT value in the transfused group was significantly higher than that in the non-transfused group (147.24 ± 85.54 s vs 98.06 ± 61.59 s, P = .011). Using 106 seconds as the dividing point, the incidence of blood transfusion in the elevated PFA-200 (CT > 106 s) group was significantly higher than those in normal PFA-200 (CT ≤ 106 s) group (10/24 patients, 41.9% vs 7/47 patients, 14.7%, P = .012). Multivariate logistic regression analysis showed that PFA-200 CT value > 106 s was an independent predictor of postoperative blood transfusion (OR: 4.05, 95%CI: 1.19-13.86, P = .026). The platelet function test PFA-200 had a predictive value for postoperative blood transfusion in elective cardiac surgery and had a promising prospect in the timing of cardiac surgery.
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Cui et al. (2023) conducted an observational in Elective cardiac surgery on dual antiplatelet therapy (n=71). Elevated PFA-200 closure time (> 106 s) vs. Normal PFA-200 closure time (≤ 106 s) was evaluated on Postoperative blood transfusion (OR 4.05, 95% CI 1.19-13.86, p=0.026). Preoperative PFA-200 closure time >106 seconds independently predicted postoperative blood transfusion in patients undergoing elective cardiac surgery (OR 4.05; 95% CI 1.19-13.86; P=0.026).
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