• Tesse C Leunissen, Janssen Paul W A PW Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands; St Antonius Center for Platelet Function Researc, Jurriën M Ten Berg, Frans L Moll, Suzanne J A Korporaal, Gert Jan de Borst, Gerard Pasterkamp, and Rolf T Urbanus.
• Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Heidelberglaan, 100, 3584 CX Utrecht, The Netherlands; Department of Vascular Surgery, University Medical Center Utrecht, Heidelberglaan, 100, 3584 CX Utrecht, The Netherlands. Electronic address: T.C.Leunissen@umcutrecht.nl.
• Vascul. Pharmacol. 2016 Feb 1; 77: 19-27.

AbstractMany patients are treated with platelet inhibitors such as aspirin and clopidogrel for prevention of thrombotic cardiovascular events. However, the inhibitory effect of antiplatelet therapy is variable between patients; in some, the platelets are hardly inhibited, while in others, the platelets are excessively inhibited. The newer and more potent platelet inhibitors, prasugrel and ticagrelor, often lead to low platelet reactivity, which potentially leads to bleeding events. Preoperative measurement of platelet reactivity in patients receiving platelet inhibitors who undergo cardiac surgery, could be useful to identify those with low platelet reactivity and thus have an increased risk of bleeding during or after surgery. In this review, we discuss the most commonly used platelet inhibitors and platelet function tests. Furthermore, we will provide an overview of the evidence for the prediction of post-operative bleeding at the operation site with preoperative platelet reactivity testing in patients undergoing cardiac surgery. Copyright © 2015 Elsevier Inc. All rights reserved.

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