Lack of Correlation Between Verifynow and TEG-Platelet Mapping in Ventricular Assist Device Patients. (21st September 2018)

• Record Type: Journal Article
• Authors: Monroig-Bosque, Paloma del C; Salazar, Eric
• Is Part Of: American journal of clinical pathology. Volume 150(2018)Supplement 1
• Page Start: S157
• Page End: S158
• Publication Date: 2018-09-21
• Subjects: Diagnosis, Laboratory -- Periodicals; Pathology -- Periodicals; 616.07
• DOI: 10.1093/ajcp/aqy112.368
• Languages: English
• ISSNs: 0002-9173

Abstract

Abstract: Ventricular assist device (VAD) patients must maintain a precarious coagulable state, in which the patient does not develop bleeding complications and the ventricular device does not thrombose. Bleeding is a frequent cause of admission in ventricular assist device patients, and pump thrombosis can have devastating consequences. Typically, patients are anticoagulated with warfarin with routine monitoring of INR. Aspirin is often used as an antiplatelet agent, although in some patients, P2Y12 inhibitors, such as clopidogrel, can also be used. Several assays are available for assessment of antiplatelet effect, including Verifynow, TEG platelet mapping (TEG-PM), and traditional platelet aggregation, among others. In this study, we sought to assess the correlation between TEG-PM and Verifynow results in ventricular assist device patients as a first step in determining which assay may be beneficial for guiding antiplatelet therapy. From December 1, 2016, to December 1, 2017, antiplatelet testing with TEG-PM and Verifynow was run in parallel on all VAD patients presenting to the outpatient clinic. Aspirin effect was assessed in 151 patients, with some on repeated visits, for a total of 553 measurements. P2Y12 inhibitor effect was assessed in 38 patients, with some on repeated visits, for a total of 107 measurements. Verifynow results in platelet reaction units were plotted against TEG-PM results in percent inhibition. Linear regression analysis was performed to determine correlation. Our assessment of the aspirin effect showed very poor correlation between the two tests with an R 2 of 0.0856. P2Y12 inhibitor effect assessment also showed very poor correlation with an R 2 of 0.0015. Overall, our data showed antiplatelet effect measured with two common antiplatelet monitoring devices did not correlate in VAD patients.