Point-of-Care Platelet Function Testing Predicts Bleeding in Patients Exposed to Clopidogrel Undergoing Coronary Artery Bypass Grafting: Verify Pre-Op TIMI 45—A Pilot Study
Dr. Reed et al from the Cleveland Clinic conducted this prospective study to assess whether VerifyNow point-of-care platelet testing could predict bleeding in 39 patients receiving Plavix and undergoing CABG. Patients in higher PRU quartiles experienced smaller decreases in hematocrit and less bleeding. By ROC analysis, a PRU threshold of ≤207 was the optimal threshold for discrimination of major bleeding during surgery, with 85% sensitivity and an 89% NPV.
Question: Should VerifyNow platelet testing be used as a discriminator for timing of CABG rather than waiting the guideline-recommended 5 days for patients who have received Plavix?
The VerifyNow testing might also be helpful in candidates with an urgent indication to weigh the individual risk of bleeding against the risk of postponing surgery.