News | March 10, 2011

New Guidelines Recommend Platelet Reactivity Testing Before Surgery

March 10, 2011 – New guidelines have been published in The Annals of Thoracic Surgery that include point-of-care testing for platelet reactivity as a new recommendation for preoperative patient assessment.

Coronary artery bypass graft (CABG) patients on antiplatelet drugs have an increased risk of excessive perioperative bleeding. Clopidogrel (Plavix) is often discontinued for five to seven days before surgery to reduce this bleeding risk. Due to the considerable variability in patient response to clopidogrel, the guidelines recommend point-of-care testing to "identify clopidogrel non-responders, who are candidates for early operative coronary revascularization and who may not require a preoperative waiting period after clopidogrel discontinuation."

The VerifyNow P2Y12 Test, from Accumetrics, allows clinicians to measure the actual level of platelet reactivity in patients who have taken P2Y12 inhibitors, such as Plavix, and who have discontinued them prior to surgery. By integrating this information with other clinical data, clinicians are able to make more informed decisions regarding a patient's treatment and surgery schedule to minimize bleeding risk.

"As the guidelines recommend, it is very important to know which patients are at risk of bleeding," said Alex Zapolanski, M.D., cardiac surgery director at The Valley Heart and Vascular Institute in Ridgewood, N.J. "We use the VerifyNow P2Y12 Test as a key piece of data to help us decide when a patient can be taken to surgery. We have found by incorporating the test into our practice that we have been able to reduce the average pre-surgical patient length of stay by three days, resulting in significant cost savings."

The system is widely used where antiplatelet medications are prescribed to reduce the occurrence of future thrombotic events such as heart attack and stroke.

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