Impact of Test Conditions on ADP-Induced Platelet Function Results With the Multiplate Assay: Is Further Standardization Required?

Dézsi, Döme A.; Merkely, Béla; Skopál, Judit; Barabás, Eszter; Várnai, Katalin; Faluközy, József; Veress, Gábor; Alotti, Nasri; Aradi, Dániel

doi:10.1177/1074248417728287

Cited by 6 publications

(6 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Then, platelet function was stable over at least three hours for citrate samples and until 60 to 240 min for hirudin samples [14,44,45,47,49]. A similar trend was observed for patients taking clopidogrel assessed by ADP-MEA, which however presented a more pronounced peak of platelet aggregability at 30 min, by comparison with clopidogrel-naive patients [50]. Few data are available for TRAP tests.…”

Section: Platelet Functionsupporting

confidence: 52%

Effects of Time-Interval since Blood Draw and of Anticoagulation on Platelet Testing (Count, Indices and Impedance Aggregometry): A Systematic Study with Blood from Healthy Volunteers

Hardy¹,

Lessire²,

Kasikci³

et al. 2020

JCM

View full text Add to dashboard Cite

Platelet count, indices (mean volume, young—immature platelet fraction) and aggregation are widely used laboratory parameters to investigate primary hemostasis. We performed a systematic, thorough evaluation of the influence of the time-interval since blood draw from 20 healthy individuals and of the anticoagulation of collected blood on such parameters. Blood was anticoagulated with citrate, K2-ethylenediaminetetraacetic acid (EDTA) and hirudin and analyzed 5, 30, 60, 120 and 180 min after blood draw. Multiple electrode aggregometry (MEA) was performed with either hirudin (half-diluted with NaCl) or citrate samples (half-diluted with NaCl or CaCl2 3 mM). Platelet count and indices (Sysmex XN-20) were rather stable over time with EDTA blood. MEA results were lower with citrate blood than with hirudin blood; supplementation with calcium was partially compensatory. MEA results were also lower when performed less than 30 or more than 120 min after blood draw. Platelet clumping, quantitatively estimated with microscope examination of blood smears, was more important in hirudin blood than citrate or EDTA blood and could explain some of the differences observed between preanalytical variables. The results stress once more the importance of preanalytical variables in hemostasis laboratory testing. Decision thresholds based on those tests are only applicable within specific preanalytical conditions.

show abstract

Section: Platelet Functionsupporting

confidence: 52%

Effects of Time-Interval since Blood Draw and of Anticoagulation on Platelet Testing (Count, Indices and Impedance Aggregometry): A Systematic Study with Blood from Healthy Volunteers

Hardy¹,

Lessire²,

Kasikci³

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…This finding is in agreement with previous reports showing that impedance aggregometry in whole blood is very sensitive to blood storage time. Dézsi et al observed a significant drop of ADP-induced aggregation as measured by the Multiplate ® Analyzer from 1 to 4 h post blood collection [39], while both Jilma-Stohlawetz et al and Johnson et al reported a significant decline of platelet function and the increase of result variability, even after 2-3 h post blood sampling [40,41].…”

Section: Discussionmentioning

confidence: 98%

The MICELI (MICrofluidic, ELectrical, Impedance): Prototyping a Point-of-Care Impedance Platelet Aggregometer

Roka‐Moiia

Bozzi

Ferrari

et al. 2020

IJMS

View full text Add to dashboard Cite

As key cellular elements of hemostasis, platelets represent a primary target for thrombosis and bleeding management. Currently, therapeutic manipulations of platelet function (antithrombotic drugs) and count (platelet transfusion) are performed with limited or no real-time monitoring of the desired outcome at the point-of-care. To address the need, we have designed and fabricated an easy-to-use, accurate, and portable impedance aggregometer called “MICELI” (MICrofluidic, ELectrical, Impedance). It improves on current platelet aggregation technology by decreasing footprint, assay complexity, and time to obtain results. The current study aimed to optimize the MICELI protocol; validate sensitivity to aggregation agonists and key blood parameters, i.e., platelet count and hematocrit; and verify the MICELI operational performance as compared to commercial impedance aggregometry. We demonstrated that the MICELI aggregometer could detect platelet aggregation in 250 μL of whole blood or platelet-rich plasma, stimulated by ADP, TRAP-6, collagen, epinephrine, and calcium ionophore. Using hirudin as blood anticoagulant allowed higher aggregation values. Aggregation values obtained by the MICELI strongly correlated with platelet count and were not affected by hematocrit. The operational performance comparison of the MICELI and the Multiplate® Analyzer demonstrated strong correlation and similar interdonor distribution of aggregation values obtained between these devices. With the proven reliability of the data obtained by the MICELI aggregometer, it can be further translated into a point-of-care diagnostic device aimed at monitoring platelet function in order to guide pharmacological hemostasis management and platelet transfusions.

show abstract

“…Recent studies analyzed the correlation of ADP- induced platelet aggregation with time to MEA measurement with conflicting results. In 11 patients, treated with clopidogrel there was a relevant time-dependent decrease of ADP–induced platelet reactivity (120 min vs. 30 min: − 34% and 240 min vs. 30 min: − 49%) [ 9 ]. In contrast, healthy volunteers had a significant increase in ADP- platelet reactivity when the time since blood collection passed, however with a minor clinical relevance of 10% increase (180 min vs 30 min) [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, results of MEA vary according to patient characteristics and may also depend on pre-analytic factors [ 8 ]. Previous studies with small sample sizes and predominant healthy patients performed MEA analysis at different time points since blood draw and showed conflicting results of platelet aggregation [ 9 , 10 ]. Data from a larger cohort of patients with comorbidities and medication in clinical practice is needed.…”

Section: Introductionmentioning

confidence: 99%

Time from blood draw to multiple electrode aggregometry and association with platelet reactivity

Hesselbarth

Gjermeni

Szabó

et al. 2022

J Thromb Thrombolysis

View full text Add to dashboard Cite

Results from multiple electrode aggregometry (MEA) may vary according to pre-analytic factors. This study aimed to analyze the association of time from blood draw to MEA in patients undergoing percutaneous coronary intervention (PCI). In this observational single-center cohort study, platelet aggregation (aggregation units, U) was quantified by MEA (Multiplate Analyzer) after stimulation with adenosine diphosphate (ADP; final concentration [Fc] 6.4 μM), thrombin receptor activating peptide (TRAP; Fc 32 μM), or arachidonic acid (AA; Fc 0.5 mM) in patients treated with ASA and clopidogrel following PCI. High on-clopidogrel platelet reactivity (HPR) was defined as ADP-induced platelet aggregation ≥ 46 U. The manufacturer recommends performing the analysis within 30–180 min after blood draw. Patients were grouped according to the time from blood draw to MEA: 30–180 min, < 30 min, or > 180 min. Platelet function of 273 patients with coronary artery disease undergoing PCI with dual antiplatelet therapy was analyzed. The median age was 72 years (interquartile range, IQR 62–79) and 179 (66%) were male. Median ADP-, TRAP-, and AA-induced aggregation was 25 (IQR 18–36) U, 79 (IQR 63–96) U, and 12 (IQR 7–18) U, respectively. For those analyzed within 30–180 min from blood draw, no significant correlation of time from blood draw to MEA was observed 1) ADP (r = − 0.04, p = 0.51); 2) TRAP (r = − 0.06, p = 0.32); 3) AA (r = − 0.03, p = 0.67). In patients undergoing percutaneous coronary intervention and treated with dual antiplatelet therapy, the time from blood draw to multiple electrode aggregometry does not correlate with ADP- induced aggregation when the measurement occurred within the recommended time interval of 30–180 min after blood draw.

show abstract

Impact of Test Conditions on ADP-Induced Platelet Function Results With the Multiplate Assay: Is Further Standardization Required?

Abstract: Test conditions may have profound impacts on the obtained results with the Multiplate assay. Our findings highlight the large influence of the time from sample collection until testing, suggesting that measurements should be performed within an hour of blood collection.

Cited by 6 publications

References 23 publications

Effects of Time-Interval since Blood Draw and of Anticoagulation on Platelet Testing (Count, Indices and Impedance Aggregometry): A Systematic Study with Blood from Healthy Volunteers

Effects of Time-Interval since Blood Draw and of Anticoagulation on Platelet Testing (Count, Indices and Impedance Aggregometry): A Systematic Study with Blood from Healthy Volunteers

The MICELI (MICrofluidic, ELectrical, Impedance): Prototyping a Point-of-Care Impedance Platelet Aggregometer

Time from blood draw to multiple electrode aggregometry and association with platelet reactivity

Contact Info

Product

Resources

About