Application of thrombelastography in assessing the effect of antiplatelet therapy and analysis of its related factors

doi:10.3969/j.issn.1009-0126.2017.02.009

Abstract：Objective To assess the application of thrombelastography (TEG) in assessing the effect of antiptatelet therapy and analyze its related factors.Methods Nine hundred and fifty-five retired male officer aged ≥60 years admitted to our hospital for TEG from June 2015 to August 2015 were divided into aspirin treatment group (n=368),clopidogrel treatment group (n=115),double antiplatelet drug treatment group (n=43),and non-antiplatelet drug treatment group (n=429) according to the antiplatelet drugs they used.The effect of antiplatelet drugs was assessed by TEG.The related factors influencing the effect of antiplatelet therapy were analyzed by multivariate logistic regression analysis.Results The inhibition rate of platelets in AA pathway and ADP pathway was 48 ％ ±19.3 ％ in aspirin treatment group,63.0 ％ ±-18.2 ％ in clopidogrel treatment group,51.0％ ± 16.5％ and 46.0％ ± 15.3％ respectively in double antiplatelet drug treatment group.No significant difference was found in the inhibition rate of platelets in AA pathway and ADP pathway in aspirin treatment group and clopidogrel treatment group (45.80％ vs 51.16％,76.52％ vs 67.44％,P＞0.05).Multivariate logistic regression analysis showed that the number of WBC and eGFR were the risk factors for bleeding (OR=0.891,P=0.001;OR=1.016,P=0.013).The number of platelets and HbA1c were the risk factors for thrombosis (OR =1.026,P=0.000;OR =1.358,P =0.011).Conclusion TEG is one of the effective means in assessing the effect of antiplatelet therapy in clinical practice.