Impact of preoperative antiplatelet therapy on in-hospital outcomes after coronary artery bypass grafting

The application of thromboelastogram in detection of indexes of antiplatelet therapy for coronary heart disease

BACKGROUND

This study aims to explore the application value of thromboelastogram (TEG) in antiplatelet therapy in coronary artery intervention.

METHODS

A retrospective analysis of 90 cases of coronary interventional treatment was conducted in our hospital from January 2010 to January 2012. Cases were divided into three groups, according to the kind of coronary heart disease: angina pectoris (AP) group (30 cases), unstable angina pectoris (UAP) group (30 cases) and acute myocardial infarction (AMI) group (30 cases). TEG changes in patients between the three groups were analyzed.

RESULTS

The differences in international normalized ratio (INR) and activated partial thromboplastin time (APTT) indexes among the three groups of patients were statistically significant (P<0.05), but these indexes significantly decreased in the AMI group. Furthermore, D-D, Fgb, Angle and MA indexes significantly increased in the UAP and AMI groups, compared with the AP group; while TEG regular parameter K and R values were markedly reduced. Coagulation graphics were higher in the UAP and AMI groups than in the AP group (χ²=4.261, 3.908; P<0.05), suggesting that the difference was statistically significant. In 11 cases of ischemic events, arachidonic acid (AA)-induced platelet inhibition rate was 63.63%, while adenosine diphosphate (ADP)-induced platelet inhibition rate was 36.37% (χ²=5.026; P<0.05); suggesting that ADP-induced platelet inhibition rate was markedly reduced. This is the main risk of ischemic events within three months after percutaneous coronary intervention.

CONCLUSIONS

The detection of indexes of antiplatelet therapy in coronary artery intervention is helpful for antiplatelet medication, thus can effectively reduce the incidence of ischemic events.