TABLE 4.
Algorithm-Guided Treatment Using Antifactor (Heparin, Enoxaparin) and Antiplatelet (Aspirin, Clopidogrel) Medications; Comparison of 10 Before/After Thromboelastography With Platelet Mapping
| Anticoagulation Medications | Thromboelastography With Platelet Mapping Variables | Inflammatory Markers | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Patient No. | Antifactor | Antiplatelet | Treatment | Reaction Time | Alpha Angle | MA | MA-Adenosine Diphosphate | MA-Arachidonic Acid | Lysis at 30 Min | Activator F | d-dimer | C-Reactive Protein | Ferritin |
| 1 | Heparin 5,000 BID | None | Initial | 5.0 | 73.8 | 70 | 68 | 70.3 | 0 | 18 | 0.96 | 2.1 | 986 |
| Heparin 5,000 BID | Aspirin 81 mg | Based on TEG | 7.0 | 68.3 | 69 | 67 | 32.5 | 0 | 20 | 1.1 | 3.5 | 1,516 | |
| 2 | None | None | Initial | 3.8 | 80.2 | 79 | 66 | 62.9 | 1 | 19.8 | 2.1 | 12 | 816 |
| Heparin 5,000 BID | Aspirin 81 mg | Based on TEG | 4.2 | 78.1 | 72 | 74 | 31.4 | 3 | 25.1 | 1.7 | 3.1 | 524 | |
| 3 | None | None | Initial | 3.2 | 79.2 | 79 | 75 | 81.4 | 0 | 28 | 1.5 | 17 | 1,089 |
| Heparin 5,000 BID | Aspirin 325 mg | Based on TEG | 4.2 | 77.1 | 77 | 76 | 42.9 | 0 | 28 | 4.3 | 1.3 | 1,256 | |
| 4 | Enoxaparin 40 QD | Aspirin 325 mg | Initial | 5.9 | 76.1 | 80 | 83 | 84.3 | 1 | 26.9 | 1.1 | 2.5 | 990 |
| Enoxaparin 40 BID | Aspirin 81 mg, clopidogrel 75 mg | Based on TEG | 7.1 | 69.7 | 78 | 77 | 62.9 | 0 | 26 | Not available | 1.1 | 829 | |
| 5 | None | None | Initial | 4.6 | 75.3 | 77 | 86 | 78.5 | 0 | 33 | 4.7 | 11 | 1,639 |
| Enoxaparin 100 BID | Aspirin 81 mg | Based on TEG | 7.2 | 66 | 72 | 55 | 57.1 | 0 | 19 | 4.2 | 6.8 | 1,080 | |
| 6 | Heparin 5,000 TID | None | Initial | 7.8 | 78.3 | 86 | 87 | 87.3 | 0 | 43 | 2.8 | 12.3 | 787 |
| Heparin 5,000 TID | Aspirin 81 mg, clopidogrel 75 mg | Based on TEG | 3.8 | 80.4 | 83 | 40 | 58.1 | 0 | 34 | 1.2 | 3.1 | 284 | |
| 7 | Enoxaparin 40 QD | Clopidogrel 75 mg | Initial | 4.7 | 79 | 81 | 76 | 82.9 | 0 | 35 | 1.5 | 15.8 | 206 |
| Enoxaparin 40 QD | Aspirin 81 mg | Based on TEG | 3.3 | 78.9 | 81 | 77 | 40 | 0 | 31 | 3.5 | 4.46 | 150 | |
| 8 | Enoxaparin 40 QD | None | Initial | 4.3 | 74.9 | 69 | 78 | 68.4 | 2 | 16 | 1.89 | 0.29 | 124 |
| Enoxaparin 30 BID | Aspirin 81 mg | Based on TEG | 4.7 | 73.5 | 69 | 68 | 49.3 | 3 | 15 | 1.09 | 0.19 | 91 | |
| 9 | Enoxaparin 100 BID | None | Initial | 5.1 | 74.5 | 71 | 72 | 76.5 | 1 | 19 | 9.3 | 4.2 | 490 |
| Enoxaparin 80 BID | Aspirin 81 mg | Based on TEG | 4.8 | 75.4 | 59 | 38 | 35 | 0 | 17 | 2.96 | 2.3 | 274 | |
| 10 | Enoxaparin 40 QD | None | Initial | 3.7 | 77.2 | 76 | 53 | 71.1 | 0 | 25 | 4.05 | 5.9 | 2,079 |
| Enoxaparin 100 BID | Aspirin 81 mg, clopidogrel 75 mg | Based on TEG | 4.5 | 71.6 | 68 | 34 | 24.7 | 0 | 12 | 11.5 | 3.5 | 2,041 | |
BID = twice daily, MA = maximum amplitude, QD = once daily, R = reaction time, TEG = thromboelastography, TID = three times daily.