The effectiveness of platelet supplementation for the reversal of ticagrelor-induced inhibition of platelet aggregation: An in-vitro study

European Journal of Anaesthesiology
Anne-Céline MartinAnne Godier

Abstract

Management of ticagrelor-induced bleeding is challenging, as no antidote is currently available. Platelet transfusion, usually proposed to reverse antiplatelet drugs, has been suggested to be ineffective but few data are available. To assess the efficacy of platelet supplementation to restore platelet aggregation inhibited by ticagrelor. In vitro study. Blood samples were obtained from the French Blood Bank Institute. Healthy blood donors. Whole blood from healthy donors was spiked with ticagrelor or aspirin (used as a positive control). Platelet aggregation was investigated with impedance aggregometry on whole blood [expressed in ohms (V)] and light transmission aggregometry (expressed in %) on platelet-rich plasma using ADP or arachidonic acid as agonists for ticagrelor or aspirin, respectively. Platelet supplementation was defined as the addition of washed platelet suspension increasing at least 60% of whole blood platelet count. Ticagrelor (3.25 mM) inhibited ADP-induced platelet aggregation compared with control either in whole blood (2 vs. 13 V, P < 0.05) or in platelet-rich plasma (15 vs. 75% P < 0.05). Aspirin (25 mM) inhibited arachidonic acid-induced aggregation (1 vs. 7.5 V, P < 0.05 in whole blood and 5 vs. 77.5%, P...Continue Reading

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Citations

Sep 4, 2016·Scandinavian Cardiovascular Journal : SCJ·Emma C Hansson, Anders Jeppsson
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