Observational studyCritical care (London, England)2014
Platelet aggregation and clot formation in comatose survivors of cardiac arrest treated with induced hypothermia and dual platelet inhibition with aspirin and ticagrelor; a prospective observational study.
Observational study in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Cangrelor in critically ill patients with cardiogenic shock or post-cardiac arrest undergoing percutaneous coronary intervention: a systematic review and meta-analysis.Critical care (London, England) · 2025Pooled it
- The impact of mild therapeutic hypothermia on platelet reactivity in comatose survivors of cardiac arrest with acute myocardial infarction treated with ticagrelor.Cardiology journal · 2024Trial
- Cangrelor - Expanding therapeutic options in patients with acute coronary syndrome.Cardiology journal · 2024Article
- Ticagrelor effectively inhibits platelet aggregation in comatose survivors of cardiac arrest undergoing primary percutaneous coronary intervention treated with mild therapeutic hypothermia.Cardiology journal · 2023Observational
- Sonoclot's usefulness in prediction of cardiopulmonary arrest prognosis: A proof of concept study.Open medicine (Warsaw, Poland) · 2022Article
- Enhanced Blood Clotting After Rewarming From Experimental Hypothermia in an Intact Porcine Model.Frontiers in physiology · 2022Article
- Does ticagrelor effectively inhibit platelets in patients undergoing mild therapeutic hypothermia or it does not?Cardiology journal · 2022Article
- Impact of mild therapeutic hypothermia on bioavailability of ticagrelor in patients with acute myocardial infarction after out-of-hospital cardiac arrest.Cardiology journal · 2020Article
- Effect of hypothermia on haemostasis and bleeding risk: a narrative review.The Journal of international medical research · 2019Review
- The value of Sonoclot detection technology to guide the clinical medication of the perioperative anticoagulation and antiplatelet therapy in patients with acute myocardial infarction undergoing emergent PCI.Experimental and therapeutic medicine · 2017Article
- Influence of temperature on thromboelastometry and platelet aggregation in cardiac arrest patients undergoing targeted temperature management.Critical care (London, England) · 2016Article
- Efficacy of enteral ticagrelor in hypothermic patients after out-of-hospital cardiac arrest.Clinical research in cardiology : official journal of the German Cardiac Society · 2016Observational
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWe conducted a prospective observational study in cardiac arrest survivors treated with mild induced hypothermia, evaluating different platelet function tests at hypo- and normothermia. We also investigated the relation between gastric emptying and vasodilator stimulated phosphoprotein (VASP).
methodsComatose survivors of out of hospital cardiac arrest were included and divided into two groups, depending on whether dual platelet inhibition with peroral ticagrelor and aspirin was given or not. The first blood samples (T1) were collected 12-24 hours after reaching target temperature (33°C) and were compared to blood samples collected 12-28 hours after reaching normothermia (37°C) (T2) within each group. All samples were analysed by Sonoclot viscoelasticity, flow cytometry based VASP and with multiple electrode aggregometry, Multiplate®; adenosine diphosphate (ADP), collagen (COL), thrombin receptor agonist peptide (TRAP) and arachidonic acid (ASPI). Sonoclot and Multiplate® instruments were set on in vivo temperatures. Gastric secretion from the nasogastric tube was measured to assess absorption of per orally administered antiplatelet drugs. Differences between T1 and T2 within each group were calculated using Wilcoxon matched pairs signed test. Significance levels were set at P <0.01.
resultsIn total, 23 patients were included. In patients with dual platelet inhibition (n =14) Multiplate®-analyses showed no changes in ADP stimulated platelets. COL, TRAP and ASPI aggregations were higher at T2 compared to T1. Sonoclot-analyses showed that activated clotting time (ACT) was unchanged but both clot rate (CR) and platelet function (PF) were higher at T2 compared to T1. VASP decreased from 53 ± 28(T1) to 24 ± 22(T2), (P <0.001). The average volume of gastric secretion aspirated before T1 correlated well with VASP (T1), r =0.81 (P <0.001). In patients with no platelet inhibition, (n =9) similar changes between T1 and T2 were seen as in patients with dual platelet inhibition while VASP was unchanged.
conclusionsWe have demonstrated increased platelet aggregation and strengthened clot formation over time in out of hospital cardiac arrest patients treated with hypothermia. In patients on oral dual platelet inhibition, the effect of ticagrelor was delayed, probably due to slow gastric emptying.
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