Platelet Reactivity in Patients on a Thienopyridine and Awaiting Coronary Artery Bypass Grafting (Serial CABG)
研究概览
详细说明
The recent emergence of platelet reactivity testing as a potential option for evaluating the degree of platelet inhibition promises to add another level of understanding to our concept of CABG-related bleeding. There is an emerging literature that links high levels of platelet reactivity with adverse clinical events, primarily in patients on clopidogrel.
For example, studies of the VerifyNow P2Y12 platelet function assay have shown that Platelet Reactivity Units (PRU) > 235-240 in patients on clopidogrel therapy appears to predict cardiovascular events.15,16 There is a paucity of literature, however, on the use of platelet reactivity testing to predict bleeding events and complications. In other words, if excessively high levels of platelet reactivity predict ischemic events, do excessively low levels of platelet reactivity predict bleeding events? This is an especially relevant question, given the emergence of prasugrel as a therapeutic option.
The investigators therefore propose an exploratory cohort study of patients receiving a thienopyridine (clopidogrel or prasugrel) and undergoing CABG, in order to describe levels of platelet reactivity in such patients by using a variety of platelet function tests.
研究类型
注册 (实际的)
阶段
- 不适用
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Patients ≥ 18 years old from both genders.
- Taking maintenance thienopyridine therapy within 5 days of surgery OR received a loading dose of thienopyridine therapy within 48 hours of surgery for CABG.
- Referred for CABG (which is scheduled to be performed during the current admission).
Exclusion Criteria:
- Known allergies to aspirin, clopidogrel, or prasugrel.
- Use of a glycoprotein (GP) IIb/IIIa inhibitor within 8 hours of initial platelet reactivity testing.
- Patient known to be pregnant or lactating.
- Patient with known history of bleeding diathesis or currently active bleeding.
- Platelet count <100,000/mm the day of initial blood draw.
- Hematocrit <25% the day of initial blood draw.
- On warfarin therapy at the time of initial blood draw.
- Known blood transfusion within the preceding 10 days of the blood draw.
- Patients treated with non-steroidal anti-inflammatory drugs (NSAIDS) within the previous 5 days.
- Plan for patient to be discharged before undergoing CABG.
- Any significant medical condition that, in the investigator's opinion, may interfere with the patient's optimal participation in the study.
学习计划
研究是如何设计的？
设计细节
- 主要用途：诊断
- 分配：不适用
- 介入模型：单组作业
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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其他：CABG
|
Platelet reactivity, as measured by the Chrono-log Lumi-Aggregometer, VerifyNow P2Y12 assay, and Vasodilator Stimulated Phosphoprotein (VASP) flow cytometry assay.
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Serial levels of platelet reactivity, as assessed with the Chrono-log Lumi-Aggregometer
大体时间：Duration of hospital stay; average hospital stay of 1 week
|
Serial levels of platelet reactivity, as assessed with the Chrono-log Lumi-Aggregometer, which measures levels of light transmittance after stimulation with ADP to estimate levels of platelet aggregation
|
Duration of hospital stay; average hospital stay of 1 week
|
|
Perioperative rates of bleeding complications
大体时间：Duration of hospital stay; average hospital stay of 1 week
|
Perioperative rates of bleeding complications:
|
Duration of hospital stay; average hospital stay of 1 week
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Serial levels of platelet reactivity, as assessed with the VerifyNow P2Y12 assay
大体时间：Duration of hospital stay; average hospital stay of 1 week
|
Serial levels of platelet reactivity, as assessed with the VerifyNow P2Y12 assay, which measures platelet reactivity units (PRUs)
|
Duration of hospital stay; average hospital stay of 1 week
|
|
Serial levels of platelet reactivity, as assessed with the Vasodilator Stimulated Phosphoprotein (VASP) assay
大体时间：Duration of hospital stay; average hospital stay of 1 week
|
Serial levels of platelet reactivity, as assessed with the Vasodilator Stimulated Phosphoprotein (VASP) assay, which measures percentage of platelet reactivity inhibition (PRI) by flow cytometry of the VASP-P protein
|
Duration of hospital stay; average hospital stay of 1 week
|
合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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