Assessment of platelet inhibition secondary to clopidogrel and aspirin therapy in preoperative acute surgical patients measured by Thrombelastography®

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Assessment of platelet inhibition secondary to clopidogrel and aspirin therapy in preoperative acute surgical patients measured by Thrombelastography® Platelet Mapping™ T.C. Collyer, D.J. Gray, R. Sandhu, J. Berridge, G. Lyons British Journal of Anaesthesia Volume 102, Issue 4, Pages 492-498 (April 2009) DOI: 10.1093/bja/aep039 Copyright © 2009 British Journal of Anaesthesia Terms and Conditions

Fig 1 TEG® Platelet Mapping™ result. The trace represents a patient who has recently ceased clopidogrel and has a respective 90% platelet ADP receptor inhibition. The x-axis represents time and the y-axis millimetres. MAThrombin, maximal amplitude with thrombin-stimulated platelets and fibrin meshwork; MAADP, maximal amplitude with ADP-stimulated platelets and fibrin meshwork; MAFibrin, maximal amplitude with fibrin meshwork. British Journal of Anaesthesia 2009 102, 492-498DOI: (10.1093/bja/aep039) Copyright © 2009 British Journal of Anaesthesia Terms and Conditions

Fig 2 TEG® Platelet Mapping™ result. The trace represents a patient who before surgery did not take any antiplatelet agent. The tracings show 0% platelet ADP inhibition. The x-axis represents time and the y-axis millimetres. MAThrombin, maximal amplitude with thrombin-stimulated platelets and fibrin meshwork; MAADP, maximal amplitude with ADP-stimulated platelets and fibrin meshwork; MAFibrin, maximal amplitude with fibrin meshwork. British Journal of Anaesthesia 2009 102, 492-498DOI: (10.1093/bja/aep039) Copyright © 2009 British Journal of Anaesthesia Terms and Conditions

Fig 3 Scatter plot of raw thrombelastography maximal amplitude (TEG MA) data of the MAFibrin, MAADP, MAAA, and MAThrombin channels from Thrombelastography® Platelet Mapping™. The thick horizontal line represents the mean with all the individual data points shown. British Journal of Anaesthesia 2009 102, 492-498DOI: (10.1093/bja/aep039) Copyright © 2009 British Journal of Anaesthesia Terms and Conditions

Fig 4 Scatter plot of thromboxane A2 (TxA2) receptor inhibition in all groups, day 1 after antiplatelet cessation. The horizontal lines represent the mean with all individual data points shown. P-value was calculated by one-way anova. British Journal of Anaesthesia 2009 102, 492-498DOI: (10.1093/bja/aep039) Copyright © 2009 British Journal of Anaesthesia Terms and Conditions

Fig 5 Scatter plot of platelet adenosine diphosphate (ADP) receptor inhibition in all groups, day 1 after antiplatelet cessation. The horizontal lines represent the mean with all individual data points shown. P-value was calculated by one-way anova. British Journal of Anaesthesia 2009 102, 492-498DOI: (10.1093/bja/aep039) Copyright © 2009 British Journal of Anaesthesia Terms and Conditions