Correlation between PlateletWorks(®) and PFA-100(®) for Measuring Platelet Function before Urgent Surgery in Patients with Chronic Antiplatelet Therapy

Hemostasis is crucial for reducing bleeding during surgical procedures. The points-of-care based on the platelet function test could be useful to minimize the complications related to chronic antiplatelet therapy during surgery. The present study is aimed at comparing two point-of-care platelet function devices—Platelet Function Analyzer PFA-100(®) (Siemens Canada, Mississauga, ON, Canada) and Plateletworks(®)(Helena Laboratories, Beaumont, TX, USA). Our objective is to evaluate if they provide comparable and useful information to manage anti-aggregate patients before surgery. We included patients with a femoral fracture receiving chronic antiplatelet therapy and a median age of 89 years (range from 70 to 98). A platelet function evaluation was performed on all patients before surgery using both devices—Plateletworks(®) and PFA-100(®). The correlation between Plateletworks(®) and PFA-100(®) was performed using Cohen’s Kappa coefficient. Twenty consecutive patients participated in the trial; 16 patients were under treatment with 75 mg/day of clopidogrel, three with >300 mg/day of acetylsalicylic acid (ASA), and only one was in treatment with both antiplatelet agents. Cohen’s Kappa coefficient was 0.327 comparing PFA-100(®)-ADP (adenosine diphosphate) and Plateletworks(®) and, 0.200 comparing PFA-100(®)-EPI (epinephrine) and Plateletworks(®). In conclusion, we found a weak concordance comparing PFA-100(®) and Plateletworks(®). This could partially be due to the advanced age of the included patients. However, given the limited sample size, more studies are necessary to confirm these results.