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CC BY-NC-ND 4.0 · Semin Thromb Hemost 2023; 49(02): 192-200
DOI: 10.1055/s-0042-1757545
Review Article

Modified Thromboelastography for Peri-interventional Assessment of Platelet Function in Cardiology Patients: A Narrative Review

Jan Hartmann
1   Haemonetics Corp., Boston, Massachusetts
,
Nick Curzen
2   Faculty of Medicine, University of Southampton & Cardiothoracic Department, University Hospital Southampton, United Kingdom
› Author Affiliations Funding/Acknowledgment Editorial assistance was provided by Meridian HealthComms Ltd., funded by Haemonetics SA, Signy, Switzerland, in accordance with Good Publication Practice (GPP3).
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Abstract

Viscoelastic testing (VET), such as thromboelastography, can measure whole blood coagulation dynamics in real time and is used across a range of clinical settings, including cardiac surgery, liver transplant, and trauma. The use of modified thromboelastography with platelet function assessment (TEG(R) PlateletMapping(R) Assay) can provide an analysis of platelet contribution to hemostasis, including the contribution of the P2Y12 receptor and thromboxane pathway to platelet function. The TEG PlateletMapping Assay has shown high correlation with the current gold standard test of platelet function, light transmission aggregometry, to measure arachidonic acid and adenosine diphosphate agonist-induced platelet activation. Studies have also shown comparable results with other whole blood platelet function tests. In this review, we explore the clinical applications of modified thromboelastography with platelet function assessment. This includes guiding dual antiplatelet therapy in relation to cardiac procedures, such as percutaneous coronary interventions, transcatheter aortic valve replacement, and left atrial appendage closure. We also explore the developing use of thromboelastography in the emergency care setting of coronavirus disease 2019, which is commonly associated with a hypercoagulable and hypofibrinolytic state. Despite a general lack of high-quality, grade 1 evidence regarding the use of modified thromboelastography with platelet function assessment in these disease areas, the ability of the TEG PlateletMapping Assay to measure global hemostasis and platelet reactivity rapidly and to view and evaluate results at the point of care makes it a promising area for further study for managing patient treatment and optimizing hemostatic therapy.

Keywords

cardiology - platelet function - platelet function testing - thromboelastography - TEG - COVID-19 - percutaneous coronary interventions - PCI - TAVR - LAAC


Publication History

Article published online:
17 October 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Hartmann J, Murphy M, Dias JD. Viscoelastic hemostatic assays: moving from the laboratory to the site of care-a review of established and emerging technologies. Diagnostics (Basel) 2020; 10 (02) E118
    CrossrefPubMedGoogle Scholar
  • 2 Faraoni D, DiNardo JA. Viscoelastic hemostatic assays: update on technology and clinical applications. Am J Hematol 2021; 96 (10) 1331-1337
    CrossrefPubMedGoogle Scholar
  • 3 Erdoes G, Koster A, Levy JH. Viscoelastic coagulation testing: use and current limitations in perioperative decision-making. Anesthesiology 2021; 135 (02) 342-349
    CrossrefPubMedGoogle Scholar
  • 4 Gonzalez E, Moore EE, Moore HB. et al. Goal-directed Hemostatic Resuscitation of Trauma-induced Coagulopathy: a pragmatic randomized clinical trial comparing a viscoelastic assay to conventional coagulation assays. Ann Surg 2016; 263 (06) 1051-1059
    CrossrefPubMedGoogle Scholar
  • 5 Baksaas-Aasen K, Gall LS, Stensballe J. et al. Viscoelastic haemostatic assay augmented protocols for major trauma haemorrhage (ITACTIC): a randomized, controlled trial. Intensive Care Med 2021; 47 (01) 49-59
    CrossrefPubMedGoogle Scholar
  • 6 Shore-Lesserson L, Manspeizer HE, DePerio M, Francis S, Vela-Cantos F, Ergin MA. Thromboelastography-guided transfusion algorithm reduces transfusions in complex cardiac surgery. Anesth Analg 1999; 88 (02) 312-319
    CrossrefPubMedGoogle Scholar
  • 7 Redfern RE, Fleming K, March RL. et al. Thrombelastography-directed transfusion in cardiac surgery: impact on postoperative outcomes. Ann Thorac Surg 2019; 107 (05) 1313-1318
    CrossrefPubMedGoogle Scholar
  • 8 Kang YG, Martin DJ, Marquez J. et al. Intraoperative changes in blood coagulation and thrombelastographic monitoring in liver transplantation. Anesth Analg 1985; 64 (09) 888-896
    PubMedGoogle Scholar
  • 9 Wang SC, Shieh JF, Chang KY. et al. Thromboelastography-guided transfusion decreases intraoperative blood transfusion during orthotopic liver transplantation: randomized clinical trial. Transplant Proc 2010; 42 (07) 2590-2593
    CrossrefPubMedGoogle Scholar
  • 10 Cotton BA, Minei KM, Radwan ZA. et al. Admission rapid thrombelastography predicts development of pulmonary embolism in trauma patients. J Trauma Acute Care Surg 2012; 72 (06) 1470-1475 , discussion 1475–1477
    CrossrefPubMedGoogle Scholar
  • 11 Hartmann J, Ergang A, Mason D, Dias JD. The role of TEG analysis in patients with COVID-19-associated coagulopathy: a systematic review. Diagnostics (Basel) 2021; 11 (02) 172
    CrossrefPubMedGoogle Scholar
  • 12 Panigada M, Bottino N, Tagliabue P. et al. Hypercoagulability of COVID-19 patients in intensive care unit: a report of thromboelastography findings and other parameters of hemostasis. J Thromb Haemost 2020; 18 (07) 1738-1742
    CrossrefPubMedGoogle Scholar
  • 13 Wright FL, Vogler TO, Moore EE. et al. Fibrinolysis shutdown correlation with thromboembolic events in severe COVID-19 infection. J Am Coll Surg 2020; 231 (02) 193.e1-203.e1
    CrossrefPubMedGoogle Scholar
  • 14 Hranjec T, Estreicher M, Rogers B. et al. Integral use of thromboelastography with platelet mapping to guide appropriate treatment, avoid complications, and improve survival of patients with coronavirus disease 2019-related coagulopathy. Crit Care Explor 2020; 2 (12) e0287
    CrossrefPubMedGoogle Scholar
  • 15 Majumdar M, Waller D, Poyant J. et al. Variability of Antiplatelet Response in Patients with Peripheral Artery Disease. J Vasc Surg 2023; 77 (01) 208-215.e3
    CrossrefPubMedGoogle Scholar
  • 16 Preisman S, Kogan A, Itzkovsky K, Leikin G, Raanani E. Modified thromboelastography evaluation of platelet dysfunction in patients undergoing coronary artery surgery. Eur J Cardiothorac Surg 2010; 37 (06) 1367-1374
    CrossrefPubMedGoogle Scholar
  • 17 Wang TH, Bhatt DL, Topol EJ. Aspirin and clopidogrel resistance: an emerging clinical entity. Eur Heart J 2006; 27 (06) 647-654
    CrossrefPubMedGoogle Scholar
  • 18 Gurbel PA, Tantry US. Do platelet function testing and genotyping improve outcome in patients treated with antithrombotic agents?: platelet function testing and genotyping improve outcome in patients treated with antithrombotic agents. Circulation 2012; 125 (10) 1276-1287 , discussion 1287
    CrossrefPubMedGoogle Scholar
  • 19 Gurbel PA, Bliden KP, Guyer K. et al. Platelet reactivity in patients and recurrent events post-stenting: results of the PREPARE POST-STENTING Study. J Am Coll Cardiol 2005; 46 (10) 1820-1826
    CrossrefPubMedGoogle Scholar
  • 20 Cayla G, Cuisset T, Silvain J. et al; ANTARCTIC investigators. Platelet function monitoring to adjust antiplatelet therapy in elderly patients stented for an acute coronary syndrome (ANTARCTIC): an open-label, blinded-endpoint, randomised controlled superiority trial. Lancet 2016; 388 (10055): 2015-2022
    CrossrefPubMedGoogle Scholar
  • 21 Price MJ, Berger PB, Teirstein PS. et al; GRAVITAS Investigators. Standard- vs high-dose clopidogrel based on platelet function testing after percutaneous coronary intervention: the GRAVITAS randomized trial. JAMA 2011; 305 (11) 1097-1105
    CrossrefPubMedGoogle Scholar
  • 22 Collet JP, Cuisset T, Rangé G. et al; ARCTIC Investigators. Bedside monitoring to adjust antiplatelet therapy for coronary stenting. N Engl J Med 2012; 367 (22) 2100-2109
    CrossrefPubMedGoogle Scholar
  • 23 Sibbing D, Aradi D, Alexopoulos D. et al. Updated expert consensus statement on platelet function and genetic testing for guiding P2Y12 receptor inhibitor treatment in percutaneous coronary intervention. JACC Cardiovasc Interv 2019; 12 (16) 1521-1537
    CrossrefPubMedGoogle Scholar
  • 24 Neumann F-J, Sousa-Uva M, Ahlsson A. et al; ESC Scientific Document Group. 2018 ESC/EACTS guidelines on myocardial revascularization. Eur Heart J 2019; 40 (02) 87-165
    CrossrefPubMedGoogle Scholar
  • 25 Bochsen L, Wiinberg B, Kjelgaard-Hansen M, Steinbrüchel DA, Johansson PI. Evaluation of the TEG platelet mapping assay in blood donors. Thromb J 2007; 5: 3
    CrossrefPubMedGoogle Scholar
  • 26 Ranucci M, Baryshnikova E. Sensitivity of viscoelastic tests to platelet function. J Clin Med 2020; 9 (01) E189
    CrossrefPubMedGoogle Scholar
  • 27 Dias JD, Lopez-Espina CG, Bliden K, Gurbel P, Hartmann J, Achneck HE. TEG®6s system measures the contributions of both platelet count and platelet function to clot formation at the site-of-care. Platelets 2020; 31 (07) 932-938
    CrossrefPubMedGoogle Scholar
  • 28 Olechowski B, Dalton RT, Khanna V. et al. Detection of individual responses to clopidogrel: Validation of a novel, rapid analysis using thrombelastography 6s. Cardiovasc Ther 2018; 36 (04) e12433
    CrossrefPubMedGoogle Scholar
  • 29 Gurbel PA, Bliden KP, Tantry US. et al. First report of the point-of-care TEG: a technical validation study of the TEG-6S system. Platelets 2016; 27 (07) 642-649
    CrossrefPubMedGoogle Scholar
  • 30 Neal MD, Moore EE, Walsh M. et al. A comparison between the TEG 6s and TEG 5000 analyzers to assess coagulation in trauma patients. J Trauma Acute Care Surg 2020; 88 (02) 279-285
    CrossrefPubMedGoogle Scholar
  • 31 Erdoes G, Schloer H, Eberle B, Nagler M. Next generation viscoelasticity assays in cardiothoracic surgery: feasibility of the TEG6s system. PLoS One 2018; 13 (12) e0209360
    CrossrefPubMedGoogle Scholar
  • 32 Lloyd-Donald P, Churilov L, Cheong B. et al. Assessing TEG6S reliability between devices and across multiple time points: a prospective thromboelastography validation study. Sci Rep 2020; 10 (01) 7045
    CrossrefPubMedGoogle Scholar
  • 33 Craft RM, Chavez JJ, Bresee SJ, Wortham DC, Cohen E, Carroll RC. A novel modification of the thrombelastograph assay, isolating platelet function, correlates with optical platelet aggregation. J Lab Clin Med 2004; 143 (05) 301-309
    CrossrefPubMedGoogle Scholar
  • 34 Liu GZ, Zhang S, Sun DH. et al. Half-dose ticagrelor versus high-dose clopidogrel in reducing platelet reactivity in acute coronary syndrome patients with high on-clopidogrel platelet reactivity (divide study). Eur J Clin Pharmacol 2019; 75 (08) 1059-1068
    CrossrefPubMedGoogle Scholar
  • 35 Dias JD, Pottgiesser T, Hartmann J, Duerschmied D, Bode C, Achneck HE. Comparison of three common whole blood platelet function tests for in vitro P2Y12 induced platelet inhibition. J Thromb Thrombolysis 2020; 50 (01) 135-143
    CrossrefPubMedGoogle Scholar
  • 36 Khanna V, Armstrong PC, Warner TD, Curzen N. Prostaglandin E1 potentiates the effects of P2Y12 blockade on ADP-mediated platelet aggregation in vitro: insights using short thromboelastography. Platelets 2015; 26 (07) 689-692
    CrossrefPubMedGoogle Scholar
  • 37 Khanna V, Hobson A, Mikael R, Sambu N, Englyst N, Curzen N. Does the VerifyNow P2Y12 assay overestimate “therapeutic response” to clopidogrel? Insights using short thrombelastography. Thromb Haemost 2014; 111 (06) 1150-1159
    Article in Thieme ConnectPubMedGoogle Scholar
  • 38 Tantry US, Bliden KP, Gurbel PA. Overestimation of platelet aspirin resistance detection by thrombelastograph platelet mapping and validation by conventional aggregometry using arachidonic acid stimulation. J Am Coll Cardiol 2005; 46 (09) 1705-1709
    CrossrefPubMedGoogle Scholar
  • 39 Khanna V, Mikael R, Thayalasamy K. et al. Does the response to aspirin and clopidogrel vary over 6 months in patients with ischemic heart disease?. J Thromb Haemost 2015; 13 (06) 920-930
    CrossrefPubMedGoogle Scholar
  • 40 Sambu N, Radhakrishnan A, Englyst N, Weir N, Curzen N. “Aspirin resistance” in ischemic stroke: insights using short thrombelastography. J Stroke Cerebrovasc Dis 2013; 22 (08) 1412-1419
    CrossrefPubMedGoogle Scholar
  • 41 Sambu N, Dent H, Englyst N. et al. Effect of clopidogrel withdrawal on platelet reactivity and vascular inflammatory biomarkers 1 year after drug-eluting stent implantation: results of the prospective, single-centre CESSATION study. Heart 2011; 97 (20) 1661-1667
    CrossrefPubMedGoogle Scholar
  • 42 Olechowski B, Ashby A, Mariathas M, Khanna V, Mahmoudi M, Curzen N. Is arachidonic acid stimulation really a test for the response to aspirin? Time to think again?. Expert Rev Cardiovasc Ther 2017; 15 (01) 35-46
    CrossrefPubMedGoogle Scholar
  • 43 Hobson AR, Qureshi Z, Banks P, Curzen NP. Effects of clopidogrel on “aspirin specific” pathways of platelet inhibition. Platelets 2009; 20 (06) 386-390
    CrossrefPubMedGoogle Scholar
  • 44 Chandler WL, Brown AF, Chen D. et al. External quality assurance of platelet function assays: results of the College of American Pathologists Proficiency Testing Program. Arch Pathol Lab Med 2019; 143 (04) 472-482
    CrossrefPubMedGoogle Scholar
  • 45 Hartmann J. External quality assurance of platelet function assays: results of the College of American Pathologists Proficiency Testing Program. Arch Pathol Lab Med 2019; 143 (08) 914-916
    CrossrefPubMedGoogle Scholar
  • 46 Karon BS, Tolan NV, Koch CD. et al. Precision and reliability of 5 platelet function tests in healthy volunteers and donors on daily antiplatelet agent therapy. Clin Chem 2014; 60 (12) 1524-1531
    CrossrefPubMedGoogle Scholar
  • 47 Agarwal S, Coakley M, Reddy K, Riddell A, Mallett S. Quantifying the effect of antiplatelet therapy: a comparison of the platelet function analyzer (PFA-100) and modified thromboelastography (mTEG) with light transmission platelet aggregometry. Anesthesiology 2006; 105 (04) 676-683
    CrossrefPubMedGoogle Scholar
  • 48 Blais N, Pharand C, Lordkipanidzé M, Sia YK, Merhi Y, Diodati JG. Response to aspirin in healthy individuals. Cross-comparison of light transmission aggregometry, VerifyNow system, platelet count drop, thromboelastography (TEG) and urinary 11-dehydrothromboxane B(2). Thromb Haemost 2009; 102 (02) 404-411
    PubMedGoogle Scholar
  • 49 Raphael J, Mazer CD, Subramani S. et al. Society of cardiovascular anesthesiologists clinical practice improvement advisory for management of perioperative bleeding and hemostasis in cardiac surgery patients. Anesth Analg 2019; 129 (05) 1209-1221
    CrossrefPubMedGoogle Scholar
  • 50 Levine GN, Bates ER, Blankenship JC. et al; American College of Cardiology Foundation, American Heart Association Task Force on Practice Guidelines, Society for Cardiovascular Angiography and Interventions. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. J Am Coll Cardiol 2011; 58 (24) e44-e122
    PubMedGoogle Scholar
  • 51 Vranckx P, Valgimigli M, Jüni P. et al; GLOBAL LEADERS Investigators. Ticagrelor plus aspirin for 1 month, followed by ticagrelor monotherapy for 23 months vs aspirin plus clopidogrel or ticagrelor for 12 months, followed by aspirin monotherapy for 12 months after implantation of a drug-eluting stent: a multicentre, open-label, randomised superiority trial. Lancet 2018; 392 (10151): 940-949
    CrossrefPubMedGoogle Scholar
  • 52 Hahn J-Y, Song YB, Oh J-H. et al; SMART-CHOICE Investigators. Effect of P2Y12 inhibitor monotherapy vs dual antiplatelet therapy on cardiovascular events in patients undergoing percutaneous coronary intervention: the SMART-CHOICE randomized clinical trial. JAMA 2019; 321 (24) 2428-2437
    CrossrefPubMedGoogle Scholar
  • 53 Watanabe H, Domei T, Morimoto T. et al; STOPDAPT-2 Investigators. Effect of 1-month dual antiplatelet therapy followed by clopidogrel vs 12-month dual antiplatelet therapy on cardiovascular and bleeding events in patients receiving PCI: the STOPDAPT-2 randomized clinical trial. JAMA 2019; 321 (24) 2414-2427
    CrossrefPubMedGoogle Scholar
  • 54 Sharma RK, Reddy HK, Singh VN, Sharma R, Voelker DJ, Bhatt G. Aspirin and clopidogrel hyporesponsiveness and nonresponsiveness in patients with coronary artery stenting. Vasc Health Risk Manag 2009; 5: 965-972
    CrossrefPubMedGoogle Scholar
  • 55 Gurbel PA, Bliden KP, Navickas IA. et al. Adenosine diphosphate-induced platelet-fibrin clot strength: a new thrombelastographic indicator of long-term poststenting ischemic events. Am Heart J 2010; 160 (02) 346-354
    CrossrefPubMedGoogle Scholar
  • 56 Sambu N, Radhakrishnan A, Dent H. et al. Personalised antiplatelet therapy in stent thrombosis: observations from the Clopidogrel Resistance in Stent Thrombosis (CREST) registry. Heart 2012; 98 (09) 706-711
    CrossrefPubMedGoogle Scholar
  • 57 Tang YD, Wang W, Yang M. et al; CREATIVE Investigators. Randomized comparisons of double-dose clopidogrel or adjunctive cilostazol versus standard dual antiplatelet in patients with high posttreatment platelet reactivity: results of the CREATIVE trial. Circulation 2018; 137 (21) 2231-2245
    CrossrefPubMedGoogle Scholar
  • 58 Dean L. Clopidogrel therapy and CYP2C19 genotype. In: Pratt VM, Scott SA, Pirmohamed M. et al., eds. Medical Genetics Summaries. Bethesda, MD: National Center for Biotechnology Information (US); 2012
    Google Scholar
  • 59 Xu O, Hartmann J, Tang YD, Dias J. The use of thromboelastography in percutaneous coronary intervention and acute coronary syndrome in East Asia: a systematic literature review. J Clin Med 2022; 11 (13) 3652
    CrossrefPubMedGoogle Scholar
  • 60 Bliden KP, DiChiara J, Tantry US, Bassi AK, Chaganti SK, Gurbel PA. Increased risk in patients with high platelet aggregation receiving chronic clopidogrel therapy undergoing percutaneous coronary intervention: is the current antiplatelet therapy adequate?. J Am Coll Cardiol 2007; 49 (06) 657-666
    CrossrefPubMedGoogle Scholar
  • 61 Zou Y, Wang Y, Wu Y, Zhang S, Liu H, Yin T. Prediction of residual ischemic risk in ticagrelor-treated patients with acute coronary syndrome. Thromb J 2022; 20 (01) 21
    CrossrefPubMedGoogle Scholar
  • 62 Cotton JM, Worrall AM, Hobson AR. et al. Individualised assessment of response to clopidogrel in patients presenting with acute coronary syndromes: a role for short thrombelastography?. Cardiovasc Ther 2010; 28 (03) 139-146
    CrossrefPubMedGoogle Scholar
  • 63 Hobson AR, Petley G, Morton G, Dawkins KD, Curzen NP. Point-of-care platelet function assays demonstrate reduced responsiveness to clopidogrel, but not aspirin, in patients with drug-eluting stent thrombosis whilst on dual antiplatelet therapy. Thromb J 2008; 6: 1
    CrossrefPubMedGoogle Scholar
  • 64 Olechowski B, Ashby A, Sambu N, Mahmoudi M, Curzen N. Stent thrombosis patients with hyporesponsiveness to clopidogrel, prasugrel, and ticagrelor: a case series using short thromboelastography. Case Rep Med 2016; 2016: 2096181
    CrossrefPubMedGoogle Scholar
  • 65 Reardon MJ, Adams DH, Kleiman NS. et al. 2-Year outcomes in patients undergoing surgical or self-expanding transcatheter aortic valve replacement. J Am Coll Cardiol 2015; 66 (02) 113-121
    CrossrefPubMedGoogle Scholar
  • 66 Fanning J, Roberts S, Merza M. et al. Evaluation of latest viscoelastic coagulation assays in the transcatheter aortic valve implantation setting. Open Heart 2021; 8 (01) e001565
    CrossrefPubMedGoogle Scholar
  • 67 Fanning JP, Roberts S, Natani S. et al. Abstract 11978: increased early prothrombotic potential of transcatheter aortic valve implantation compared with percutaneous coronary intervention identified with viscoelastic hemostatic assessment of coagulation. Circulation 2021; 144 (01) A11978
    PubMedGoogle Scholar
  • 68 Rymuza B, Zbroński K, Scisło P. et al. Thromboelastography for predicting bleeding in patients with aortic stenosis treated with transcatheter aortic valve implantation. Kardiol Pol 2018; 76 (02) 418-425
    CrossrefPubMedGoogle Scholar
  • 69 Wintgens LIS, Maarse M, Swaans MJ, Rensing BJWM, Van Dijk VF, Boersma LVA. The WATCHMAN left atrial appendage closure device for patients with atrial fibrillation: current status and future perspectives. Expert Rev Med Devices 2020; 17 (07) 615-626
    CrossrefPubMedGoogle Scholar
  • 70 Kar S, Doshi SK, Sadhu A. et al; PINNACLE FLX Investigators. primary outcome evaluation of a next-generation left atrial appendage closure device: results from the PINNACLE FLX trial. Circulation 2021; 143 (18) 1754-1762
    CrossrefPubMedGoogle Scholar
  • 71 Sherwood M, Bliden KP, Ilkhanoff L. et al. Detailed thrombogenicity phenotyping and 1 year outcomes in patients undergoing WATCHMAN implantation: (TARGET-WATCHMAN) a case-control study. J Thromb Thrombolysis 2020; 50 (03) 484-498
    CrossrefPubMedGoogle Scholar
  • 72 Crawford TC, Magruder JT, Fraser C. et al; Investigators for the Maryland Cardiac Surgery Quality Initiative. Less is more: results of a statewide analysis of the impact of blood transfusion on coronary artery bypass grafting outcomes. Ann Thorac Surg 2018; 105 (01) 129-136
    CrossrefPubMedGoogle Scholar
  • 73 Karkouti K, Callum J, Wijeysundera DN. et al; TACS Investigators. Point-of-care hemostatic testing in cardiac surgery: a stepped-wedge clustered randomized controlled trial. Circulation 2016; 134 (16) 1152-1162
    CrossrefPubMedGoogle Scholar
  • 74 Jneid H, Anderson JL, Wright RS. et al. 2012 Writing Committee Members, American College of Cardiology Foundation, American Heart Association Task Force on Practice Guidelines. 2012 ACCF/AHA focused update of the guideline for the management of patients with unstable angina/Non-ST-elevation myocardial infarction (updating the 2007 guideline and replacing the 2011 focused update): a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation 2012; 126 (07) 875-910
    CrossrefPubMedGoogle Scholar
  • 75 Mahla E, Suarez TA, Bliden KP. et al. Platelet function measurement-based strategy to reduce bleeding and waiting time in clopidogrel-treated patients undergoing coronary artery bypass graft surgery: the timing based on platelet function strategy to reduce clopidogrel-associated bleeding related to CABG (TARGET-CABG) study. Circ Cardiovasc Interv 2012; 5 (02) 261-269
    CrossrefPubMedGoogle Scholar
  • 76 Yang Z, Xie Z, Pei X, Quan X, Feng D. Effect of thrombelastography on timing of coronary artery bypass grafting. Exp Ther Med 2018; 16 (02) 579-584
    PubMedGoogle Scholar
  • 77 Laubscher GJ, Lourens PJ, Venter C, Kell DB, Pretorius E. TEG®, microclot and platelet mapping for guiding early management of severe COVID-19 coagulopathy. J Clin Med 2021; 10 (22) 5381
    CrossrefPubMedGoogle Scholar
  • 78 Grobler C, Maphumulo SC, Grobbelaar LM. et al. Covid-19: the rollercoaster of fibrin(ogen), D-dimer, von Willebrand factor, P-selectin and their interactions with endothelial cells, platelets and erythrocytes. Int J Mol Sci 2020; 21 (14) E5168
    CrossrefPubMedGoogle Scholar
  • 79 Gurbel PA, Bliden KP, Levy JH. et al. Thrombogenicity markers for early diagnosis and prognosis in COVID-19: a change from the current paradigm?. Blood Coagul Fibrinolysis 2021; 32 (08) 544-549
    CrossrefPubMedGoogle Scholar
  • 80 Ankola AA, Bradford VR, Newburger JW. et al. Coagulation profiles and viscoelastic testing in multisystem inflammatory syndrome in children. Pediatr Blood Cancer 2021; 68 (12) e29355
    CrossrefPubMedGoogle Scholar
  • 81 Morparia K, Spinella PC, McQueen D. et al. Thromboelastography profiles in critically ill children with multisystem inflammatory syndrome. Pediatr Blood Cancer 2022; 69 (05) e29426
    CrossrefPubMedGoogle Scholar
  • 82 Chaudhary R, Kreutz RP, Bliden KP, Tantry US, Gurbel PA. Personalizing antithrombotic therapy in COVID-19: role of thromboelastography and thromboelastometry. Thromb Haemost 2020; 120 (11) 1594-1596
    Article in Thieme ConnectPubMedGoogle Scholar
  • 83 Stillson JE, Bunch CM, Gillespie L. et al. Thromboelastography-guided management of anticoagulated COVID-19 patients to prevent hemorrhage. Semin Thromb Hemost 2021; 47 (04) 442-446
    Article in Thieme ConnectPubMedGoogle Scholar
  • 84 Gurbel PA, Bliden KP, Rout A. et al. Bedside thromboelastography to rapidly assess the pharmacodynamic response of anticoagulants and aspirin in COVID-19: evidence of inadequate therapy in a predominantly minority population. J Thromb Thrombolysis 2021; 51 (04) 902-904
    CrossrefPubMedGoogle Scholar