Open AccessEstablishing a reference range for thromboelastography maximum amplitude in patients administrating with antiplatelet drugs
Author(s) -
Shen Wei,
Zhou JingYi,
Gu Yi,
Shen WenYan,
Li Min
Publication year - 2020
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.23144
Subject(s) - thromboelastography , clopidogrel , aspirin , medicine , reference range , receiver operating characteristic , percentile , platelet , cardiology , gastroenterology , anesthesia , mathematics , statistics
Objective We aimed to establish the reference range of thromboelastograph (TEG) maximum amplitude (MA) in patients taking antiplatelet drugs. Methods Between August 2015 and July 2018, a total of 4614 patients administrating with antiplatelet drugs (clopidogrel and aspirin) were retrospectively analyzed in this study. For MA A parameter, we used the 10th and 90th percentiles to establish a reference range. The Spearman correlation was used for the correlation analysis among the inhibition rate of adenosine diphosphate (ADP%) and MA ADP , inhibition rate of arachidonic acid (AA%) and MA AA . Then, through receiver operating characteristic (ROC) curve analysis of the best cutoff point, the reference ranges of MA ADP and MA AA could be deduced. Consistency evaluation was performed by statistical analysis of ADP% and MA ADP , AA% and MA AA pairing for 4459 patients. Results The reference range of MA A was 8.1‐25.8 mm. The reference range of MA ADP was 19.8‐43.2 mm, and the corresponding sensitivity of two endpoints was 0.796, 0.856 and specificity were 0.897, 0.904, respectively. The reference range of MA AA was 18.9‐37.7 mm, and the corresponding sensitivity of two endpoints was 0.819, 0.829 and specificity were 0.922, 0.896, respectively. The inconsistency rate of ADP% and MA ADP , and AA% and MA AA was 20.1% (898 cases) and 16.6% (738 cases), respectively. Conclusions The reference range of MA ADP and MA AA established by us were better in sensitivity and specificity. MA ADP and MA AA were more accurate than conventional inhibition rate analysis in guidance of antiplatelet therapy, especially in patients with excessive low MA or high MA A .