Multiple electrode aggregometry: A new device to measure platelet aggregation in whole blood

Tóth, Orsolya; Calatzis, Andreas; Penz, Sandra; Losonczy, Hajna; Siess, Wolfgang

doi:10.1160/th06-05-0242

Cited by 405 publications

(40 citation statements)

References 21 publications

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“…An increased maximum clot firmness (MCF) or maximum amplitude in ROTEM™ or TEG™, respectively, reflects hypercoagulability and is predictive for postoperative thromboembolic events [29,30]. Platelet dysfunction can be reliably assessed at the bedside by whole-blood impedance aggregometry (Multiplate™; Roche Diagnostics, Mannheim, Germany) [31,32]. The interpretation of platelet function is however limited to a platelet count <50,000/µl [33].…”

Section: Whole-blood Coagulation and Testing Of Platelet Functionmentioning

confidence: 99%

Delicate Balance of Bleeding and Thrombosis in End-Stage Liver Disease and Liver Transplantation

Saner

Gieseler²,

Akız³

et al. 2013

Digestion

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Liver transplantation in cirrhotic patients is accompanied by severe bleeding. Indeed, the first 100 recipients of liver allografts transplanted by Thomas E. Starzl died mainly by uncontrolled bleeding. Since then, much progress has been made as to the understanding of the pathophysiology and the treatment of hemostatic disorders in cirrhotic patients. The aim of this review is to provide a state-of-the-art overview on recent developments and treatment options for hemostatic disorder in cirrhotic patients. Patients with end-stage-liver disease (ESLD) do not suffer only from procoagulant deficiency; there is also a lack of natural anticoagulants (i.e. proteins C and S) and profibrinolytics. Conventional laboratory methods such as the determination of the international normalized ratio or the activated partial thromboplastin time cannot predict bleeding complications in these patients. Progressive diagnostic techniques reveal that cirrhotic patients have the same capacity to produce thrombin like healthy volunteers. Moreover, cirrhotic patients - and particularly those with primary biliary cirrhosis or primary sclerosing cholangitis - are at a higher risk for developing thrombosis as compared with healthy controls. Hemostatic alterations are common in cirrhotic patients; they involve both the pro- and the anticoagulant pathways. However, this is a very delicate balance, which may be shifted to either of these pathways by different treatments thereby causing bleeding or thrombosis, respectively.

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Section: Whole-blood Coagulation and Testing Of Platelet Functionmentioning

confidence: 99%

Delicate Balance of Bleeding and Thrombosis in End-Stage Liver Disease and Liver Transplantation

Saner

Gieseler²,

Akız³

et al. 2013

Digestion

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“…The method has been described in detail elsewhere [11]. Specifically, the adhesion and aggregation of platelets on sensor surfaces enhance the electrical resistance between 2 sensor electrodes.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Three Tests to Distinguish Platelet Reactivity in Patients with Renal Impairment during Dual Antiplatelet Therapy

Guo

Kim²,

Kim³

et al. 2016

Nephron

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Background: Clopidogrel and aspirin combination remains a cornerstone for modern dual antiplatelet therapy (DAPT) following coronary stenting. Although monitoring is not currently recommended, certain high-risk cohorts may benefit from tailoring antiplatelet options to reduce thrombotic or/and hemorrhagic risks. Patients with diminished estimated glomerular filtration rate (eGFR) are prone to both vascular occlusions and bleeding events in whom monitoring may be especially advantageous. We compared the residual platelet reactivity assessed by 3 conventional tests during the maintenance antiplatelet therapy dependent on eGFR. Methods: Post-stenting patients (n = 701) receiving aspirin 100 mg/daily and clopidogrel 75 mg/daily were prospectively enrolled in the cross-sectional single-center study. Patients were dichotomized into 5 groups: eGFR >90, 60-89, 30-59, <30 ml/min/1.73 m², and dialysis. Platelet reactivity by VerifyNow™, light transmittance aggregometry (LTA), and Multiplate analyzer by multiple electrode platelet aggregometry (MEA) assays together with eGFR calculations were done simultaneously at 1 month after coronary stenting. Results: VerifyNow assay distinguished residual platelet reactivity dependent on eGFR deterioration (191 ± 72 vs. 216 ± 78 vs. 248 ± 80 vs. 264 ± 70 vs. 317 ± 96 PRU; p < 0.001). In contrast, LTA (34.3 ± 18.1 vs. 34.7 ± 18.1 vs. 38.0 ± 16.6 vs. 33.0 ± 17.3 vs. 34.1 ± 29.3%; p = 0.242), or MEA (37.2 ± 19.6 vs. 33.8 ± 18.4 vs. 38.6 ± 21.4 vs. 36.5 ± 20.5 vs. 38.3 ± 28.3 AU/min; p = 0.086) failed to triage platelet reactivity in renal patients. Agreement among assays to identify patients with impaired platelet reactivity and eGFR during antiplatelet therapy was low. The multivariable regression analyses confirmed the VerifyNow advantage, since the differences in the platelet reactivity were highly significant for all renal impairment (RI) groups. In contrast, LTA did not distinguish RI patients, and for the MEA, only RI5 (dialysis) cohort exhibit borderline significant decline of residual platelet reactivity. Conclusion: Among 3 assays, VerifyNow was capable to reliably triage residual platelet reactivity in post-stenting DAPT patients dependent on the gradual decline of eGFR during therapy with clopidogrel and aspirin. These data should be confirmed in a large validation longitudinal trial, and may justify future platelet activity monitoring for potential regimen/dose adjustment in high-risk patients. The clinical implications of these data are still unclear, but may give an indication as to whether or when DAPT dose adjustment will become a reality.

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“…Blood cell counts, coagulation and chemistry parameters were measured using standardized laboratory methods. Thromboelastometry and platelet function tests were performed within three hours of blood collection on citrated whole blood by trained personnel using an automated ROTEM ® delta device (Tem International GmbH, Germany) and a MULTIPLATE ® function analyzer (Roche Diagnostics GmbH, Germany) [17] according to standardized procedures and the manufacturer's recommendations. EXTEM, INTEM, and FIBTEM assays were performed for each enrolled patient and the following parameters were measured: i) clotting time (CT, s), the time from the beginning of the coagulation analysis until an increase in amplitude of 2 mm.…”

Section: Laboratory Testsmentioning

confidence: 99%

“…The MULTIPLATE ® platelet function analysis takes place in a single-use test cell, which incorporates dual copper sensor wires [17]. When activated, platelets adhere to the sensor wires thus increasing the electrical resistance (i.e., impedance).…”

Section: Laboratory Testsmentioning

confidence: 99%

Whole-blood hypocoagulable profile correlates with a greater risk of death within 28 days in patients with severe sepsis

Boscolo

Spiezia

Campello

et al. 2020

Korean J Anesthesiol

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Despite continually updated sepsis/septic shock guidelines and bundles [1] recommending early diagnosis and prompt initiation of therapy, sepsis remains a challenge worldwide. The overall mortality rate of septic shock ranges from 25-30%, reaching 40-60% among hospitalized patients [1][2][3][4][5]. Sepsis is a complex systemic defense mechanism to an overwhelming infection. The inflammatory response against an invading pathogen is the result of several hemostatic alterations, notably the dysregulation of pro-and anti-coagulant factors [6][7][8][9]. Although hypocoagulability appears to accurately predict a fatal outcome in sepsis, conventional coagulation tests are unable to reliably detect sep-

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Multiple electrode aggregometry: A new device to measure platelet aggregation in whole blood

Cited by 405 publications

References 21 publications

Delicate Balance of Bleeding and Thrombosis in End-Stage Liver Disease and Liver Transplantation

Delicate Balance of Bleeding and Thrombosis in End-Stage Liver Disease and Liver Transplantation

Comparison of Three Tests to Distinguish Platelet Reactivity in Patients with Renal Impairment during Dual Antiplatelet Therapy

Whole-blood hypocoagulable profile correlates with a greater risk of death within 28 days in patients with severe sepsis

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