Gabriel Raviv

First report of the point-of-care TEG: A technical validation study of the TEG-6S system

Abstract Thrombelastography (TEG) measured by the TEG5000 Hemostasis Analyzer is an established but the labor-intensive method for assessing global hemostasis. The first true point-of-care TEG, the TEG6s system, uses resonance-frequency viscoelasticity measurements and a disposable multi-channel microfluidic cartridge to assess hemostasis and response to antiplatelet therapy. TEG assays (n = 5,100) were performed on the blood of healthy volunteers (n = 157) and patients undergoing coronary revascularization at three hospitals (n = 300). The results from the TEG6s were compared with the conventional TEG5000 in accordance with Clinical and Laboratory Standards Institute (CLSI) and FDA recommendations. Precision testing was conducted using blood from healthy donors, all assays were run for 5 consecutive days in duplicate using multiple operators, lots, and instruments. Reference ranges were comparable between the TEG systems. Deming regression analysis demonstrated a strong correlation between the two systems for the standard hemostasis tests (R r = 0.932, MA r = 0.972, LY30 r = 0.938). Method comparison analysis showed an acceptable agreement between PlateletMapping (PM) assays for measuring arachidonic acid (indicator of aspirin response)- and adenosine diphosphate (indicator of P2Y12 inhibitor response)-induced platelet aggregation (total agreement = 90%, and 72%, respectively). TEG6s precision testing yielded low variability (CV 0–13%) in all measures. The new point-of-care TEG6s is associated with greater ease of use than the TEG5000 and provides precise results. The results correlated between methods for all variables. TEG6s is a promising device for near-patient hemostasis monitoring and future trials of personalized therapy designed to reduce bleeding and thrombosis.

POINT-OF-CARE ASSESSMENT OF NOAC-INDUCED ANTICOAGULATION: THE NOVEL HAEMONETICS TEG 6S SYSTEM

New oral anticoagulants (NOACs) including direct thrombin inhibitors (DTIs) and Xa inhibitors offer major advantages over vitamin K antagonists. Although officially these agents do not require monitoring, bleeding and ischemic events occur raising concerns for over or under inhibition during NOAC

ASSESSMENT OF THROMBOGENICITY AND ANTITHROMBOTIC DRUG RESPONSE AT THE BEDSIDE IN PATIENTS PRESENTING WITH ISCHEMIC STROKE, TIA OR INTRACRANIAL HEMORRHAGE

Background: Early assessment of antithrombotic effects may be important for therapeutic decision making in patients presenting with stroke and TIA. Methods: In this prospective observational study, 80 patients presenting with symptoms suggestive of stroke and 45 patients with stroke-like symptoms