초록접수[미리보기]
| 21KF-020 |
To continue or not to continue that is the problem: Aspirin before interventional proceures
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea1
Department of Anesthesiology and Pain Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea2
Department of Anesthesiology and Pain Medicine, Ajou University Hospital, Suwon, Korea3
Background
The expanding use of antiplatelet agents has resulted in increased procedure-related bleeding risk. Especially when a patient needs interventional procedures, it is important for the clinician to understand potential antiplatelet effects. Many patients discontinue antiplatelet agents unconditionally according to recent guidelines. However, these guidelines were not based on the platelet function test. So we conducted platelet function tests to determine whether patients should stop taking antiplatelet agents before the procedures.
Methods
The platelet function test was performed on all first-visiting patients with Platelet Function Analyzer-100 device. The patients who were utilizing Aspirin(ASA) were categorized into the ASA medication (A) group, and those who did not utilize ASA were categorized into the non-medication (N) group. Closure times (CT) was measured using the collagen/epinephrine cartridge. Prolonged CTs were defined as CT >182 seconds with Col/EPI.
Results
A total of 1128 patients were included in this study. In the A group, 57.2% (111/194) showed normal platelet function, and only 42.8% (83/194) showed abnormal. In the N group, 75% (801/944) showed abnormal platelet function, and 15% (143/944) showed abnormal test results.
Conclusion
Patients who are taking antiplatelet medication show a higher percentage of normal platelet function than expected. Also, it should be noted that abnormal findings may appear in 15% of patients who are not taking the antiplatelets. It is not reasonable to stop aspirin unconditionally.
The expanding use of antiplatelet agents has resulted in increased procedure-related bleeding risk. Especially when a patient needs interventional procedures, it is important for the clinician to understand potential antiplatelet effects. Many patients discontinue antiplatelet agents unconditionally according to recent guidelines. However, these guidelines were not based on the platelet function test. So we conducted platelet function tests to determine whether patients should stop taking antiplatelet agents before the procedures.
Methods
The platelet function test was performed on all first-visiting patients with Platelet Function Analyzer-100 device. The patients who were utilizing Aspirin(ASA) were categorized into the ASA medication (A) group, and those who did not utilize ASA were categorized into the non-medication (N) group. Closure times (CT) was measured using the collagen/epinephrine cartridge. Prolonged CTs were defined as CT >182 seconds with Col/EPI.
Results
A total of 1128 patients were included in this study. In the A group, 57.2% (111/194) showed normal platelet function, and only 42.8% (83/194) showed abnormal. In the N group, 75% (801/944) showed abnormal platelet function, and 15% (143/944) showed abnormal test results.
Conclusion
Patients who are taking antiplatelet medication show a higher percentage of normal platelet function than expected. Also, it should be noted that abnormal findings may appear in 15% of patients who are not taking the antiplatelets. It is not reasonable to stop aspirin unconditionally.
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