PMC5075289_01
Short thromboelastography traces showing adequate response to aspirin 150 mg daily and hyporesponse to P2Y12 inhibitors in first patient. (a) Patient 1 clotting response to AA when on 150 mg daily aspirin, producing a %CI(AA) of 71, an adequate response to aspirin. (b) Patient 1 clotting response to ADP when on 75 mg clopidogrel daily, producing a %CI(ADP) of 17 (nonresponse to clopidogrel). (c) Patient 1 clotting response to ADP when on 10 mg prasugrel daily, producing a %CI(ADP) of 9 (nonresponse to prasugrel). (d) Patient 1 clotting response to ADP when on 90 mg ticagrelor twice daily, producing a %CI(ADP) of 1 (nonresponse to ticagrelor).
CRIM2016-2096181.001.jpg
PMC5075289_01_CRIM2016-2096181.001.jpg
fig1
Similarly, his reading revealed hyporesponse (%CI 1) (Figure 1).
PMC5075289_02
Short thromboelastography traces showing adequate response to aspirin 75 mg daily and hyporesponse to P2Y12 inhibitors in second patient. (a) Patient 2 clotting response to AA when on 75 mg daily aspirin, producing a %CI(AA) of 61, an adequate response to aspirin. (b) Patient 2 clotting response to ADP when on 75 mg clopidogrel daily, producing a %CI(ADP) of 21 (nonresponse to clopidogrel). (c) Patient 2 clotting response to ADP when on 10 mg prasugrel daily, producing a %CI(ADP) of 17 (nonresponse to prasugrel). (d) Patient 2 clotting response to ADP when on 90 mg ticagrelor twice daily, producing a %CI(ADP) of -21 (nonresponse to ticagrelor).
CRIM2016-2096181.002.jpg
PMC5075289_02_CRIM2016-2096181.002.jpg
fig2
Finally, ticagrelor 90 mg bd was introduced, with no initial loading, with similar effect (%CI -21) after 263 days of treatment (Figure 2).
PMC5075289_03
Variability in % clotting inhibition following medication adjustments in patients found to be hyporesponsive at initial and successive short TEG tests following stent thrombosis. Horizontal dotted line signifies a sufficient response.
CRIM2016-2096181.003.jpg
PMC5075289_03_CRIM2016-2096181.003.jpg
fig3