Current Trends in Hemostatic Testing

Fareed, Jawed; Walenga, Jeanine M.

doi:10.1055/s-2007-1005037

Cited by 7 publications

(5 citation statements)

References 57 publications

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“…Noting decreases in PF4 levels or BTG levels after the institution of antiplatelet therapy may also be indicative of clinical efficacy for stopping or blunting increased fibrin deposition. [234][235][236] Some investigations, however, have failed to show decreases in PF4 or BTG levels in patients with arterial occlusive disease being treated with antiplatelet drugs. 237 Newer methods available to assess platelet hyperactivity and "consumption," most of which are amenable to full automation, are summarized in Table 16 and consist of MPV and molecular markers of platelet reactivity.…”

Section: Hyperactive Prethrombotic Plateletsmentioning

confidence: 99%

Platelet Function Defects: A Clinical Review

Bick¹

1992

Semin Thromb Hemost

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Platelet dysfunction, especially acquired forms, are common causes of hemorrhage, especially in association with trauma and surgery. Although the hereditary platelet function defects are generally quite rare, hereditary storage pool disease is common enough to be suspected in an individual, usually a child, with characteristic historical and clinical findings. The acquired platelet function defects, especially those resulting from drugs, are very common and should promptly be suspected in patients developing easy and spontaneous bruising, mild to moderate mucosal membrane hemorrhage, or unexplained bleeding associated with trauma or surgery. The template bleeding time is generally useful as a screening test of platelet function, but a normal template bleeding time, in the presence of a suggestive history, suggestive clinical findings, or in the patient frankly bleeding, is not reliable and platelet aggregation or lumi-aggregation should be done in appropriate clinical situations. The mainstay of therapy for essentially all these defects, if bleeding is significant, is the liberal infusion of appropriate numbers of platelet concentrates. The acquired platelet function defects, of course, should also be managed by attempts to treat or control the underlying disease, if possible, and offending drugs or potentially offending drugs should promptly be discontinued.

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Section: Hyperactive Prethrombotic Plateletsmentioning

confidence: 99%

Platelet Function Defects: A Clinical Review

Bick¹

1992

Semin Thromb Hemost

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“…Our current knowledge regarding the generation of various low molecular weight markers of physiologic events has led to the development of panels of tests to detect these contrast-induced reactions. [75][76][77][78][79] Unlike conventional methods, these tests are performed on native, nonactivated plasma or whole blood, providing a true picture of the physiologic status of a given patient. The clinical application of this concept of molecular markers is relatively new; we have utilized these sensitive assays to attempt to detect changes in the blood that may represent a very early stage of a serious reaction.…”

Section: Fig 3 Molecular Structure Of a Bridged (Bimolecular)mentioning

confidence: 99%

“…15,38,87,90,91,111,[121][122][123]125,159,166,193 Measurement of molecular markers' action of pathologic activation has provided a reliable tool to study the underlying triggering mechanism involved in the production of contrast-induced adverse reactions. 79,148,162,163,178 The individual components of physiologic processes are regulated by various biochemical pathways and their activation and inhibition result in the release or depression of the release of certain enzymes, products of enzyme reactions, and other well-defined chemicals that can be measured to assess specific aspects of the overall system. 76,77,85,139 A list of various humoral systems that can be modulated by contrast agents is given in Table 1.…”

Section: Fig 3 Molecular Structure Of a Bridged (Bimolecular)mentioning

confidence: 99%

Molecular Markers of Contrast Media-Induced Adverse Reactions

Fareed¹,

Moncada²,

Messmore³

et al. 1984

Semin Thromb Hemost

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Currently used routine laboratory screening methods are not reliable in the prediction of contrast media-related adverse reactions. Cost-effective laboratory methods for various molecular markers of pathophysiologic activation have now become available. In vitro activation tests in high-risk patients may prove to be useful in the prediction of contrast-induced activation of various adverse reactions. If prior clinical evaluation of a patient suggests an ongoing pathologic process, profiling of the following molecular markers may prove to be useful and helpful in avoiding contrast-induced adverse reactions: Fibrinopeptide A, platelet factor 4, thromboxane B2, 5-HETE, physiologic inhibitors of proteases, B beta 15-42 related peptides, bradykinin/kininogen, and anaphylactozins. In patients suspected of reacting to contrast agents, a small dose of 1 to 5 ml can be injected as a bolus and molecular marker profiling on blood drawn after the infusion may prove to be useful screening tests. Additional clinical studies are needed to prove this. However, this screening test should be performed with extreme caution, since some of the patients are known to react to as little as 1 ml dose. The safety of newly developed nonionic contrast agents can be readily assessed by profiling various molecular markers of adverse reactions, which provide a more reliable and quantitative assessment of contrast-induced adverse reactions. Based on molecular marker profiling, various prophylactic agents can be given to high-risk patients to avoid contrast-induced adverse reactions.

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“…Proper blood drawing plays a crucial role in the quantitation of the physically relevant levels of these markers. Specific guidelines have been established for the proper collection of biological fluids and storage of these samples for the analysis (26,27). Table 4 shows a compilation of the origin of various molecular markers of hemostatic activation and assay methods for their quantitation.…”

Section: Laboratory Considerationsmentioning

confidence: 99%

“…A comparison of tissue factor pathway antigen levels using various treatment protocols. Blood samples (25)(26)(27)(28)(29)(30) from patients undergoing therapeutic anticoagulation (aPTT > 40 secs), low molecular weight heparin (subcutaneous), during angioplasty and cardiac bypass surgery (during pump room) were collected. Blood was individually centrifuged and plasma frozen at -70°C.…”

Section: Figmentioning

confidence: 99%

State-of-the-Art-Review : Thrombogenesis in Myocardial Infarction and Related Syndromes: The Role of Molecular Markers in Diagnosis and Management

Fareed

Hoppensteadt

Leya

et al. 1999

Clin Appl Thromb Hemost

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Anticoagulant therapy has undergone some major developments in recent years. Conventional drugs that produce anticoagulant effects such as heparin and oral anticoagulants are no longer considered the only candidates for the anticoagulant/antithrombotic management of patients. Recombinant hirudin, glycoproteins IIb/IIIa targeting antibodies, synthetic peptides such as Hirulog and efegatran are being tested for their efficacy. These drugs produce their effects at different sites. To monitor their overall effects on the hemostatic system, molecular markers offer a practical and reliable approach. Markers of thrombin generation are useful for the monitoring of antithrombin drugs whereas, the efficacy of antiplatelet drugs can be assessed by monitoring the platelet release products. Furthermore, polytherapy using several anticoagulant and antithrombotic drugs in combination has been considered. In these situations, the use of molecular markers may also prove to be invaluable. The introduction of simple technology such as the test strip or particle agglutination methods may be available for the measurement of many of these markers in the near future. This will be useful for ready availability and reduced cost for individual marker testing. Furthermore, this type of technology can be used at bedside, off-site, and in doctor's offices. It is clear that the molecular marker profiling provides useful information on the nature of pathophysiology of a given thrombotic disorder. However, for practical use, a cost-effective and simpler assay-based approach will enhance their use, and these tests will be readily accepted at the laboratory and clinical levels.

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Current Trends in Hemostatic Testing

Cited by 7 publications

References 57 publications

Platelet Function Defects: A Clinical Review

Platelet Function Defects: A Clinical Review

Molecular Markers of Contrast Media-Induced Adverse Reactions

State-of-the-Art-Review : Thrombogenesis in Myocardial Infarction and Related Syndromes: The Role of Molecular Markers in Diagnosis and Management

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