State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296231187627. doi: 10.1177/10760296231187627.
The value of platelet function test in timing of cardiac surgery remains uncertain. Researches on correlation between Platelet Function Analyzer 200 (PFA-200) and bleeding after elective cardiac surgery are still inadequate. The objective of this study was to investigate the predictive value of PFA-200 in blood transfusion after cardiac surgery. A total of 71 patients on aspirin and P2Y12 receptor inhibitors undergoing cardiac surgery in Fuwai Hospital were enrolled. Platelet function after discontinuing of antiplatelet drugs was assessed by PFA-200 using closure time (CT). PFA-200 results before surgery were included in the statistics. The primary endpoint was postoperative blood transfusion. Seventeen patients (21.9%) received blood transfusion after cardiac surgery. The preoperative PFA-200 CT value in the transfused group was significantly higher than that in the non-transfused group (147.24 ± 85.54 s vs 98.06 ± 61.59 s, = .011). Using 106 seconds as the dividing point, the incidence of blood transfusion in the elevated PFA-200 (CT > 106 s) group was significantly higher than those in normal PFA-200 (CT ≤ 106 s) group (10/24 patients, 41.9% vs 7/47 patients, 14.7%, = .012). Multivariate logistic regression analysis showed that PFA-200 CT value > 106 s was an independent predictor of postoperative blood transfusion (OR: 4.05, 95%CI: 1.19-13.86, = .026). The platelet function test PFA-200 had a predictive value for postoperative blood transfusion in elective cardiac surgery and had a promising prospect in the timing of cardiac surgery.
血小板功能检测在心脏手术时机中的价值仍不确定。关于血小板功能分析仪 200（PFA-200）与择期心脏手术后出血之间相关性的研究仍然不足。本研究旨在探讨 PFA-200 在心脏手术后输血中的预测价值。共纳入 71 例在阜外医院服用阿司匹林和 P2Y12 受体抑制剂的行心脏手术患者。通过使用闭合力（CT）的血小板功能分析仪 200 来评估停止抗血小板药物后的血小板功能。手术前的 PFA-200 结果被纳入统计。主要终点是术后输血。17 例（21.9%）患者心脏手术后接受输血。输血组的术前 PFA-200 CT 值明显高于未输血组（147.24 ± 85.54 秒比 98.06 ± 61.59 秒，= 0.011）。以 106 秒为界点，PFA-200 升高（CT > 106 秒）组的输血发生率明显高于 PFA-200 正常组（CT ≤ 106 秒）（10/24 例，41.9%比 7/47 例，14.7%，= 0.012）。多变量逻辑回归分析显示，PFA-200 CT 值> 106 秒是术后输血的独立预测因子（OR：4.05，95%CI：1.19-13.86，= 0.026）。血小板功能检测 PFA-200 对择期心脏手术术后输血具有预测价值，在心脏手术时机方面具有广阔的应用前景。
