Comparison of Two Different Blood Sample Tubes for Platelet Function Analysis with the Multiplate® System

Loreth, R. M.; Klose, Gudrun

doi:10.1159/000319785

Cited by 7 publications

(3 citation statements)

References 7 publications

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“…Cardiology and radiology residents/fellows are exposed to higher levels of radiation than faculty members due to their educational role in health care system (3). Cardiology and radiology residents/fellows are exposed to higher levels of radiation than faculty members due to their educational role in health care system (3).…”

Section: İlhami üNlüoğlu Hamdi Kaba Departments Of Family Medicine Amentioning

confidence: 99%

Factors influencing the use of ambulance among patients with acute coronary syndrome: results of two centers in Turkey

Ünlüoğlu¹,

Kaba²

2014

Anadolu Kardiyol Derg

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We are pleased by interest and valuable comments by authors. They correctly pointed out some unclarities in our letter, as some information were not presented due to limited extend of scientific letter format (1). We are glad to supplement this information here.The first remark was about the method used for blood sample collection. EDTA containing tubes were used for mean platelet volume and platelet count examination. All samples were processed in less than 2 hours. According to the literature (2) and our experience in such settings the mean platelet volume increase does not excess 10%. Moreover, using a citrate can result in changes of mean platelet count (2). Samples for aggregometry were collected in hirudine, which seems to produce better results than citrate or lepirudine and is generally available for this method (3).Another remark concerned the potential bias caused by impact of comorbidities on mean platelet volume. In his letter a detailed summary of such confounding factors, namely smoking, obesity, hyperlipidemia, hypertension, coronary artery disease, metabolic syndrome, statin use and atrial fibrillation is presented. These associations correlate with finding that patients with higher mean platelet volume are in higher risk of ischemic heart disease (4) suggests that such bias must be excluded.We analyzed the influence of smoking, diabetes, atrial fibrillation, left ventricle systolic dysfunction (5) [ejection fraction <40% and inflammation (6) (hs-CRP >20 mg/L (7)]. C-reactive protein was measured using CRPL3 Tina-quant C-Reactive Protein Gen. 3 assays by Roche Diagnostics, Germany. Statin use was not added in statistical analysis, because only three patients were not treated using these agents. None of risk factors mentioned above was associated with increased mean platelet volume (Table 1). Regression analysis was not beneficial either.Therefore we expect that the relation of mean platelet volume to both high on-treatment platelet reactivity and increased mortality is rather based on alteration of platelet functions than by concomitant association with another risk factor. Unfortunately, number of patients is insufficient for detailed statistical evaluation. This study also cannot explain the exact etiology of platelet function impairment. Despite these limitations the study suggests that mean platelet volume can be used as marker of high on-treatment platelet reactivity and for risk stratification.

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Section: İlhami üNlüoğlu Hamdi Kaba Departments Of Family Medicine Amentioning

confidence: 99%

Factors influencing the use of ambulance among patients with acute coronary syndrome: results of two centers in Turkey

Ünlüoğlu¹,

Kaba²

2014

Anadolu Kardiyol Derg

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“…To equalise preanalytical conditions in comparative studies and to minimise blood collection volumes, it would be of advantage to use the material treated in the same way for different platelet function tests. Blood collection tubes for the Multiplate ® system contain lepirudin as anticoagulant (18)(19). Lepirudin, a recombinant hirudin ([Leu1, Thr2]-63-desulfohirudin, commercially available as Refludan ® ), acts as a direct thrombin inhibitor by forming an irreversible 1:1 stoichiometric complex with thrombin independently from antithrombin, thereby blocking the active site and exosite-1 of thrombin (20,21).…”

Section: Introductionmentioning

confidence: 99%

The thrombin inhibitors hirudin and Refludan® activate the soluble guanylyl cyclase and the cGMP pathway in washed human platelets

Kobsar¹,

Koessler²,

Kehrer³

et al. 2012

Thromb Haemost

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A number of direct thrombin inhibitors are successfully used clinically and experimentally as novel antithrombotics and specific anticoagulants. They are also used as anticoagulants in certain blood collection tubes for the analysis of platelet function. A series of platelet function tests have emerged to measure adequate responses to antiplatelet therapy. For comparative and practical reasons, it would be of advantage to use the same anticoagulant in blood collection tubes for different methods, e.g. thrombin inhibitors. However, there are little data on the effects of thrombin inhibitors on platelet signalling pathways that could influence results. We examined the applicability of thrombin inhibitor containing blood for platelet reactivity index (PRI) measurements of the VASP assay and investigated the effects of two thrombin inhibitors (hirudin and lepirudin) on cAMP- and cGMP-mediated signalling pathways in washed human platelets. We show that induction of VASP phosphorylation by PGE1 is markedly reduced in lepirudin containing blood samples. In consequence, PRI levels were highly variable compared to routinely used citrated blood. Surprisingly, in vitro incubation of platelets with thrombin inhibitors increases platelet cGMP levels and induces NOS independent sGC/PKG-mediated VASP phosphorylation. We conclude that thrombin inhibitors activate sGC/PKG-dependent pathways resulting in an increase of VASP phosphorylation which contributes to deviations in PRI measurements. These effects of thrombin inhibitors on sGC- and cGMP-mediated pathways including increased VASP phosphorylation may indicate the presence of an important additional platelet-based mechanism for the reduction of thrombus formation and thromboembolism by thrombin inhibitors.

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“…Furthermore, blood sample tubes with dried lepirudin may be beneficial compared to liquid lepirudin with regard to handling. The validation of such anticoagulants in platelet aggregation testing is an important step towards their use in the clinic and laboratory [9,10]. Further validation studies are also needed to prove the benefits proposed for the POCT platelet aggregation devices.…”

mentioning

confidence: 99%

Clinical and Laboratory Diagnosis of Inherited Platelet Function Disorders

Bugert

2010

Transfus Med Hemother

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Comparison of Two Different Blood Sample Tubes for Platelet Function Analysis with the Multiplate® System

Cited by 7 publications

References 7 publications

Factors influencing the use of ambulance among patients with acute coronary syndrome: results of two centers in Turkey

Factors influencing the use of ambulance among patients with acute coronary syndrome: results of two centers in Turkey

The thrombin inhibitors hirudin and Refludan® activate the soluble guanylyl cyclase and the cGMP pathway in washed human platelets

Clinical and Laboratory Diagnosis of Inherited Platelet Function Disorders

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