Wednesday, April 18, 2018 at 12:00 PM
This grand round has already taken place.
April 18th, 2018 1.00 AMA PRA Category 1 Credit Hours
Description
Methods to test platelet function include Aggregometry, Thromboelastography, measurement of high shear whole blood flow blocked by platelet plug, and Turbidimetric Optical Detection using Fibrinogen coated beads. P2Y12 receptor blockers are widely used in interventional Cardiology and Cerebrovascular patients. Clopidogrel is less expensive than Prasugrel, and Ticagrelor and causes less bleeding. A substantial proportion of patients show Clopidogrel resistance on platelet function tests. Poor responders to Clopidogrel who show high platelet reactivity are at increased risk for Stent Thrombosis. However, the benefit of a management strategy that incorporates routine platelet function testing is unproven.
In a bleeding emergency, reversal of Antiplatelet drugs may be accomplished by platelet transfusion. The PATCH study aimed to investigate whether platelet transfusion with standard care, compared with standard care alone, reduced death or dependence after Intracerebral Hemorrhage associated with Antiplatelet Therapy use. Surprisingly, PATCH concluded that platelet transfusion seemed to be inferior to standard care for people taking Antiplatelet Therapy before Intracerebral Hemorrhage; therefore, platelet transfusion could not be recommended for this indication in clinical practice. Neurocritical Care Society guidelines recommend platelet transfusion in the amount of one to two Apheresis Units for patients undergoing urgent Neurosurgical intervention after Clopidogrel use. Platelet testing is suggested prior to repeat transfusion, if available, and repeat transfusion should be used only for those with persistently abnormal platelet function tests and/or ongoing bleeding. The guideline cautions that the accuracy of these laboratory metrics remains unclear.
Dates and Times
Start: 4/18/2018 12:00 PM
End: 4/18/2018 1:00 PM
Objectives
• Understand and compare methods for platelet function testing.
• Describe how to reverse Antiplatelet drugs in a bleeding emergency, including the role of platelet function testing to dose platelet transfusion.
• Know current guidelines for platelet function testing in Coronary Artery Disease patients and Cerebrovascular Disease patients.
Speakers
Location
University Hospital
Level 2, Room 749
Stony Brook, NY 11794
Accreditation
The School of Medicine, State University of New York at Stony Brook, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The School of Medicine, State University of New York at Stony Brook designates this live activity for a maximum of 1.00 AMA PRA Category 1 Credit(s) ™. Physicians should only claim the credit commensurate with the extent of their participation in the activity.
Need help with this Grand Round Session?
Please contact the Grand Round coordinator listed below:
Chanel Jones
Department: Pathology
Phone: (631) 444-3156
Email: chanel.jones@stonybrookmedicine.edu