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131: PLATELET FUNCTION P2Y12 TESTING USE IN ASSESSING THE RISK FOR HEMORRHAGE IN PATIENTS ON CLOPIDOGREL

Introduction/Hypothesis: Pre-treatment with a P2Y12 inhibitor such as clopidogrel in addition to aspirin for acute coronary syndrome is a Class I recommendation by American College of Cardiology Guidelines. However, clopidogrel pre-treatment is associated with higher bleeding rates and prolonged hospitalization during complex procedures and cardiac surgery. Platelet function testing has been used to optimize the timing of surgery and bleeding reduction. We sought to retrospectively study the bleeding rates in relation to platelet function testing in clopidogrel pretreated patients. In general, PRU >230 indicates more reactive platelets, and therefore, is associated with less bleeding. Methods: There were 138 patient charts reviewed from January 2018 through October 2018. One hundred sixteen patients met inclusion criteria which included adults at least 18 years of age, admitted to NYU Winthrop Hospital, who received clopidogrel therapy, and had platelet function P2Y12 VerifyNow® results charted. Sixty-eight patients were in the PRU 230 group. The primary outcome of this study was to determine whether patients with PRU 230. Bleeding was defined by having a decrease in hemoglobin by >2 g/dL and/or being transfused >2 units of packed red blood cells. Results: There were 23.53% (16 out of 68 patients) in PRU <230 group who experienced bleeding compared to 45.83% (22 out of 48 patients) in the PRU >230 group (p=0.0117). No difference in hospital length of stay (p=0.06955) or procedure type (p >0.05) is noted between the PRU 230 group. Conclusions: Surprisingly, bleeding rates are lower in patients with PRU <230. Further larger prospective randomized studies are needed.