Association of ADP-induced platelet maximum amplitude with postoperative bleeding and blood transfusions in patients undergoing coronary artery bypass grafting surgery

Abstract Objectives To investigate the association of ADP-induced platelet maximum amplitude (MAADP) with postoperative bleeding and blood product transfusions in patients undergoing coronary artery bypass grafting surgery (CABG) with cardiopulmonary bypass (CPB). Design This single-center observational study recruited 200 patients who underwent elective, first-time, isolated CABG with CPB. Rapid-thrombelastograph (r-TEG) with platelet mapping test was conducted for all patients before the operation. They were categorized by the preoperative MAADP into ≤ 50 mm (MAADP ≤ 50 group, n = 87) and MAADP \u003e 50 (MAADP \u003e 50 group, n = 113). The primary outcome was postoperative bleeding at 6 hours and 24 hours as measured by chest tube drainage volume. The perioperative blood product transfusions, postoperative complications, postoperative time course and in-hospital mortality were also evaluated. Setting University hospital. Participants Adult patients scheduled to undergo isolated, primary CABG with CPB. Interventions None Measurements and Main Results Totally 200 patients who underwent CABG with CPB were included. MAADP was higher than 50 mm in 113 (56.5%) patients (MAADP \u003e 50 group). Compared with MAADP \u003e 50 group, the postoperative chest tube drainage volume at 6 hours and 24 hours were significantly higher in the patients with MAADP ≤ 50 (476.90 ± 156.36 mL vs. 403.36 ± 133.24 mL, P 50. The duration of intensive care unit (ICU) stay and length of postoperative hospital stay were markedly longer in the MAADP ≤ 50 group than in the MAADP \u003e 50 group (P = 0.001 and P = 0.005; respectively). There were no significant differences in adverse outcomes between the two groups except for the postoperative atrial fibrillation, which occurred more in the MAADP ≤ 50 group than in the MAADP \u003e 50 group (8.05% vs. 1.77%, P = 0.043). MAADP (area under the ROC curve of 0.767, P Conclusions Preoperative MAADP may play a potential role in the prediction of postoperative bleeding and allogenic blood transfusions and guide clinicians in perioperative management of patients undergoing CABG with CPB.