Plasma and whole blood clot strength measured by thrombelastography in patients treated with clopidogrel during acute coronary syndromes

Deshun Lu, Janelle Owens, Rolf Kreutz

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Introduction Treatment with clopidogrel, a selective platelet P 2Y12 receptor antagonist, reduces risk of recurrent ischemic events in patients with acute coronary syndrome (ACS), by limiting platelet aggregation and activation. Stable whole blood clot formation requires activation of platelets, generation of fibrin and final fibrin crosslinks. In this study we intended to compare plasma and whole blood thrombelastography (TEG) measurements in patients during ACS. Materials and Methods Whole blood and plasma samples from 32 patients with non-ST segment elevation myocardial infarction (NSTEMI) were collected after administration of clopidogrel. Whole blood and plasma fibrin clot strength (MA) were determined by TEG. Platelet aggregation was determined by light transmittance aggregometry (LTA) using adenosine 5'-diphosphate (ADP), thrombin receptor activation peptide (TRAP), or collagen as agonists. Fibrinogen and C-reactive protein (CRP) concentrations were measured by ELISA. Results Heightened plasma fibrin clot strength was associated with increased platelet reactivity stimulated by ADP (ρ = 0.536; p = 0.002), TRAP (ρ = 0.481; p = 0.007), and collagen (ρ = 0.538; p = 0.01). In contrast to plasma fibrin MA, whole blood MA did not correlate with platelet aggregation. Platelet count was the primary contributor to the difference in thrombin induced whole blood MA and plasma fibrin MA. Increasing levels of CRP were associated with increased plasma fibrin clot strength and platelet reactivity. Conclusions Our data suggest that inflammation is associated with increased plasma fibrin clot strength and lower platelet inhibition by clopidogrel during ACS. Platelet count is a main contributor to additional contractile force of whole blood TEG as compared to plasma TEG during treatment with clopidogrel.

Original languageEnglish
JournalThrombosis Research
Volume132
Issue number2
DOIs
StatePublished - Aug 2013

Fingerprint

clopidogrel
Thrombelastography
Acute Coronary Syndrome
Fibrin
Thrombosis
Blood Platelets
Platelet Aggregation
Thrombin Receptors
Platelet Activation
Platelet Count
C-Reactive Protein
Adenosine Diphosphate
Collagen
Peptides

Keywords

  • Clopidogrel
  • Coagulation
  • CRP
  • Platelet
  • Thrombelastography

ASJC Scopus subject areas

  • Hematology

Cite this

Plasma and whole blood clot strength measured by thrombelastography in patients treated with clopidogrel during acute coronary syndromes. / Lu, Deshun; Owens, Janelle; Kreutz, Rolf.

In: Thrombosis Research, Vol. 132, No. 2, 08.2013.

Research output: Contribution to journalArticle

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