Platelet function after cessation of chronic clopidogrel therapy

Peter G. Perakis, Tahir Yunus, Graham Long, Zulfiqar Cheema, Robert Hammond, Charles J. Shanley

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Surgeons increasingly encounter patients on clopidogrel therapy who are preparing to undergo surgery. The goal of this study was to examine the change in platelet function after the common clinical scenario of discontinuing chronic clopidogrel therapy in those patients preparing to undergo an elective surgery, and the time course of platelet function recovery after clopidogrel discontinuation. Patients on clopidogrel therapy scheduled for an elective surgical procedure had their platelet function tested using a VerifyNow P2Y12 device (Accumetrics, San Diego, CA). Platelet inhibition was evaluated at baseline before clopidogrel discontinuation, and subsequently studied every other day in the week before their scheduled procedure. Mean platelet inhibition was 32.1 per cent on Day 0 (before clopidogrel discontinuation), decreasing to 3.7 per cent on Day 4. Platelet inhibition decreased significantly after discontinuation of clopidogrel in a time-dependent manner (P=0.011), although a considerable interindividual variability of P2Y12 reaction units values was observed over the study period. Patients on concomitant proton pump inhibitors and clopidogrel demonstrated a decreased effect of clopidogrel. In conclusion, individual platelet function monitoring may assist the surgeon in perioperative decision-making in patients receiving clopidogrel therapy preparing to undergo elective surgery.

Original languageEnglish (US)
Pages (from-to)51-56
Number of pages6
JournalAmerican Surgeon
Volume78
Issue number1
StatePublished - Jan 2012
Externally publishedYes

Fingerprint

clopidogrel
Blood Platelets
Therapeutics
Elective Surgical Procedures
Proton Pump Inhibitors

ASJC Scopus subject areas

  • Surgery

Cite this

Perakis, P. G., Yunus, T., Long, G., Cheema, Z., Hammond, R., & Shanley, C. J. (2012). Platelet function after cessation of chronic clopidogrel therapy. American Surgeon, 78(1), 51-56.

Platelet function after cessation of chronic clopidogrel therapy. / Perakis, Peter G.; Yunus, Tahir; Long, Graham; Cheema, Zulfiqar; Hammond, Robert; Shanley, Charles J.

In: American Surgeon, Vol. 78, No. 1, 01.2012, p. 51-56.

Research output: Contribution to journalArticle

Perakis, PG, Yunus, T, Long, G, Cheema, Z, Hammond, R & Shanley, CJ 2012, 'Platelet function after cessation of chronic clopidogrel therapy', American Surgeon, vol. 78, no. 1, pp. 51-56.
Perakis PG, Yunus T, Long G, Cheema Z, Hammond R, Shanley CJ. Platelet function after cessation of chronic clopidogrel therapy. American Surgeon. 2012 Jan;78(1):51-56.
Perakis, Peter G. ; Yunus, Tahir ; Long, Graham ; Cheema, Zulfiqar ; Hammond, Robert ; Shanley, Charles J. / Platelet function after cessation of chronic clopidogrel therapy. In: American Surgeon. 2012 ; Vol. 78, No. 1. pp. 51-56.
@article{58295fc2cb57458e95e437ac709570d9,
title = "Platelet function after cessation of chronic clopidogrel therapy",
abstract = "Surgeons increasingly encounter patients on clopidogrel therapy who are preparing to undergo surgery. The goal of this study was to examine the change in platelet function after the common clinical scenario of discontinuing chronic clopidogrel therapy in those patients preparing to undergo an elective surgery, and the time course of platelet function recovery after clopidogrel discontinuation. Patients on clopidogrel therapy scheduled for an elective surgical procedure had their platelet function tested using a VerifyNow P2Y12 device (Accumetrics, San Diego, CA). Platelet inhibition was evaluated at baseline before clopidogrel discontinuation, and subsequently studied every other day in the week before their scheduled procedure. Mean platelet inhibition was 32.1 per cent on Day 0 (before clopidogrel discontinuation), decreasing to 3.7 per cent on Day 4. Platelet inhibition decreased significantly after discontinuation of clopidogrel in a time-dependent manner (P=0.011), although a considerable interindividual variability of P2Y12 reaction units values was observed over the study period. Patients on concomitant proton pump inhibitors and clopidogrel demonstrated a decreased effect of clopidogrel. In conclusion, individual platelet function monitoring may assist the surgeon in perioperative decision-making in patients receiving clopidogrel therapy preparing to undergo elective surgery.",
author = "Perakis, {Peter G.} and Tahir Yunus and Graham Long and Zulfiqar Cheema and Robert Hammond and Shanley, {Charles J.}",
year = "2012",
month = "1",
language = "English (US)",
volume = "78",
pages = "51--56",
journal = "The American surgeon",
issn = "0003-1348",
publisher = "Southeastern Surgical Congress",
number = "1",

}

TY - JOUR

T1 - Platelet function after cessation of chronic clopidogrel therapy

AU - Perakis, Peter G.

AU - Yunus, Tahir

AU - Long, Graham

AU - Cheema, Zulfiqar

AU - Hammond, Robert

AU - Shanley, Charles J.

PY - 2012/1

Y1 - 2012/1

N2 - Surgeons increasingly encounter patients on clopidogrel therapy who are preparing to undergo surgery. The goal of this study was to examine the change in platelet function after the common clinical scenario of discontinuing chronic clopidogrel therapy in those patients preparing to undergo an elective surgery, and the time course of platelet function recovery after clopidogrel discontinuation. Patients on clopidogrel therapy scheduled for an elective surgical procedure had their platelet function tested using a VerifyNow P2Y12 device (Accumetrics, San Diego, CA). Platelet inhibition was evaluated at baseline before clopidogrel discontinuation, and subsequently studied every other day in the week before their scheduled procedure. Mean platelet inhibition was 32.1 per cent on Day 0 (before clopidogrel discontinuation), decreasing to 3.7 per cent on Day 4. Platelet inhibition decreased significantly after discontinuation of clopidogrel in a time-dependent manner (P=0.011), although a considerable interindividual variability of P2Y12 reaction units values was observed over the study period. Patients on concomitant proton pump inhibitors and clopidogrel demonstrated a decreased effect of clopidogrel. In conclusion, individual platelet function monitoring may assist the surgeon in perioperative decision-making in patients receiving clopidogrel therapy preparing to undergo elective surgery.

AB - Surgeons increasingly encounter patients on clopidogrel therapy who are preparing to undergo surgery. The goal of this study was to examine the change in platelet function after the common clinical scenario of discontinuing chronic clopidogrel therapy in those patients preparing to undergo an elective surgery, and the time course of platelet function recovery after clopidogrel discontinuation. Patients on clopidogrel therapy scheduled for an elective surgical procedure had their platelet function tested using a VerifyNow P2Y12 device (Accumetrics, San Diego, CA). Platelet inhibition was evaluated at baseline before clopidogrel discontinuation, and subsequently studied every other day in the week before their scheduled procedure. Mean platelet inhibition was 32.1 per cent on Day 0 (before clopidogrel discontinuation), decreasing to 3.7 per cent on Day 4. Platelet inhibition decreased significantly after discontinuation of clopidogrel in a time-dependent manner (P=0.011), although a considerable interindividual variability of P2Y12 reaction units values was observed over the study period. Patients on concomitant proton pump inhibitors and clopidogrel demonstrated a decreased effect of clopidogrel. In conclusion, individual platelet function monitoring may assist the surgeon in perioperative decision-making in patients receiving clopidogrel therapy preparing to undergo elective surgery.

UR - http://www.scopus.com/inward/record.url?scp=84857099371&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84857099371&partnerID=8YFLogxK

M3 - Article

C2 - 22273313

AN - SCOPUS:84857099371

VL - 78

SP - 51

EP - 56

JO - The American surgeon

JF - The American surgeon

SN - 0003-1348

IS - 1

ER -