Does timing of platelet function testing (PFT) contribute to variability in residual on-treatment platelet reactivity in patients with acute coronary syndrome (ACS)?

Abstract

therapeutic anticoagulation with warfarin is challenging and hinders timely DCCV. Dabigatran is a safe and effective alternative. We evaluated the difference in time to DCCV and success rate between those on dabigatran compared to warfarin. Method: Patients who had DCCV between 12/1/2011 and 31/12/2013 were prospectively collected. Patient demographics and electronic clinical documentations were retrospectively reviewed. Results: Total of 168 DCCV were performed on 153 patients. Mean age was 61 years and mean BMI was 32kg/m with male predominance (80.4%). 87.6% of patients were referred from Cardiology and 12.4% from General Medicine. 45.2% (n = 76) were on dabigatran. The median days to DCCV with dabigatran was 63 days (IQR = 44 – 100 days) and 86 days for warfarin (IQR = 56 – 121days), p < 0.05. The overall immediate success rate of DCCVwas 80.4%. 94.1% of atrial flutter (AFL) had successful cardioversion and 76.5% for atrial fibrillation (AF). At median follow-up of 108 days, 25.5% remained in sinus rhythm (SR). Those with AFL, 50% (n = 17) remained in SR at median follow up of 69 days while 18.5% of AF remained in SR at median follow up of 130.5 days. There was no difference in the immediate success of DCCV between dabigatran and warfarin groups (80.3% vs 80.4%, p = 0.89). AF accounted for 80.3% and 77.2% respectively. Conclusion: The median time to outpatient DCCV was 23 days shorter with dabigatran compared warfarin therapy. There was no difference in success rate between the 2 anticoagulation groups.