Application of thrombelastography in antiplatelet therapy in children with Kawasaki disease

Objective To evaluate the efficacy of antiplatelet agents in patients with Kawasaki disease (KD) by using thrombelastography (TEG). Methods A retrospective study of KD patients admitted in our hospital from May 2016 to December 2016 was conducted.Platelet inhibition rates of Arachidonic acid pathway(AA%) and Adenosine diphosphate pathway were assessed using TEG platelet mapping.The effects of aspirin and dipyridamole on platelet inhibition were compared, and the differences of platelet inhibition rates in different aspirin dose and duration of medication were determined. Results There were significant individual differences in the inhibition of platelets by aspirin and dipyridamole.The inhibition rate of aspirin on platelets[M(P25, P75)] was 62.45% (35.58%, 90.95%), which was higher than that of dipyridamole[23.75% (11.60%, 48.38%)], there was significant difference (P<0.01). The incidence of dipyridamole resistance in children with KD (56.75%) was higher than that in patients with resistance to aspirin (35.71%), and there was significant difference (P<0.01). There was a linear correlation between platelet inhibition rates of two antiplatelet agents in children with KD (r=0.351, P<0.01). There was no significant difference in the effect of aspirin and dipyridamole on platelet inhibition rate after 4 days of administration.There was no significant difference in the effect of different doses of aspirin on AA%. Conclusion TEG is an effective way to evaluate the efficacy of antiplatelet therapy in children with KD. Key words: Mucocutaneous lymphnode syndrome; Thrombelastography; Children; Therapy; Platelet aggregation inhibitors