Key result
Preoperative platelet function monitoring revealed complete platelet function recovery 4 days after prasugrel discontinuation, allowing urgent CABG without increased risk of postoperative bleeding.
Why the study?
The optimal management of prasugrel in patients undergoing cardiac surgery remains challenging, and little is known regarding its impact on platelet function recovery.
Does point-of-care platelet function testing safely shorten the preoperative waiting time for urgent CABG in a patient treated with prasugrel?
Case Report (n=1)
Does point-of-care platelet function testing safely shorten the preoperative waiting time for urgent CABG in a patient treated with prasugrel?
Preoperative platelet function monitoring may safely shorten the guideline-recommended 7-day waiting time for urgent CABG in patients treated with prasugrel.
May support shorter prasugrel discontinuation before urgent CABG via platelet testing; leaves open confirmation in prospective studies.
receptor inhibitor such as prasugrel in patients undergoing cardiac surgery remains a dilemma and little is known about its impact on platelet function recovery. Guidelines recommend discontinuation of prasugrel 7 days before surgery to reduce the risk of surgery-related bleeding. Patients at risk may benefit from preoperative platelet function testing to guide individualized preoperative waiting time. We present a rare case of complete function recovery in a patient treated with prasugrel revealed by preoperative platelet function monitoring before urgent coronary artery bypass surgery (CABG). A complete platelet function recovery was revealed by platelet function testing after discontinuation of prasugrel for four days and patient underwent urgent CABG without increased risk of postoperative bleeding. Our case with a review of literature emphasized that the decision to proceed with urgent CABG in a patient recently treated with prasugrel should be based on a personalized risk assessment and might be supported by preoperative platelet function monitoring to shorten the waiting time.
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Sef et al. (2021) conducted a case report in Patient treated with prasugrel undergoing urgent CABG (n=1). Preoperative platelet function monitoring was evaluated on Platelet function recovery and postoperative bleeding. Preoperative platelet function monitoring revealed complete platelet function recovery 4 days after prasugrel discontinuation, allowing urgent CABG without increased risk of postoperative bleeding.
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