Platelet Aggregometry Testing: Molecular Mechanisms, Techniques and Clinical Implications

Koltai, Katalin; Késmárky, Gábor; Fehér, Gergely; Tibold, Antal; Tóth, Kálmán

doi:10.3390/ijms18081803

Cited by 104 publications

(87 citation statements)

References 150 publications

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“…To meet these requirements, evaluation of platelet function along with platelet count intra-operatively is pivotal. PFA-100 and MEA are two commonly used modalities to monitor platelet function and assess the need for transfusion and blood ow cessation (18). Intraoperative transfusions play a crucial role in the patient outcome; therefore, sensitive and e cient platelet function test should be performed for predicting high-risk patients.…”

Section: Discussionmentioning

confidence: 99%

Effect of Cardiopulmonary Bypass Machine on the Platelet Function Testing.

Alsaleh¹,

AlBakr²,

Albacker³

et al. 2020

Preprint

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Background: Bleeding during coronary artery bypass surgery is a leading cause of mortality. Several factors have been associated with bleeding, platelet dysfunction being the most significant.Objective: to assess the effect of cardiopulmonary bypass machine (CPB) during cardiac surgery on platelet function using Platelet Function Analyzers (PFA-100), and Multiplate Electrode Aggregometry (MEA), and correlating that with a drop in Hemoglobin (Hb).Methods: Whole blood samples were collected preoperative and sixty minutes intraoperatively of different cardiac procedures utilizing (CPB) and tested for platelet function by PFA-100 and MEA. Complete blood count was measured using an automated hematology analyzer.Results: A significant difference was found between pre- and intraoperative ADP and EPI measurement in PFA-100, where preoperative PFA-ADP values displayed the ability to predict the intra-op drop in Hb (P–value 0.01, correlation coefficient 0.4699). At the same time, pre-op MEA- Ristocetin and TRAP showed an inverse correlation with an intra-op drop in Hb (-0.31 and -0.36). Conclusion: The current study reported significant changes in platelet dysfunction in cardiac surgeries with CPB, measured by two modalities PFA-100, and MEA. While PFA-100 and MEA both detected the changes in platelet dysfunction due to CPB, PFA-100 results were sensitive and positively predicted intra-op Hb drop as compared to MEA. There was a significant change in Hb one hour into the CPB, indicating that platelet transfusion might help decrease Intra- and postoperative bleeding independent of the platelet count as they are dysfunctional. PFA-100 results can be relied upon for distinction of high-risk cardiac surgery patients for bleeding and can be used for clinical decision making to improve patient outcome.

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Section: Discussionmentioning

confidence: 99%

Effect of Cardiopulmonary Bypass Machine on the Platelet Function Testing.

Alsaleh¹,

AlBakr²,

Albacker³

et al. 2020

Preprint

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“…The TEG parameters were correlated with other clinical and laboratory data, such as LAC status, PLT level, and UTP and SLEDAI values. Patients with positive LAC status, higher PLT levels, UTP >500 mg/24 h, and higher SLEDAI values are known to have a greater risk of thrombosis. Figure shows the change in the parameters with disease severity in the active disease patient group.…”

Section: Discussionmentioning

confidence: 99%

Evaluating hypercoagulability in new‐onset systemic lupus erythematosus patients using thromboelastography

Gong

Shi

Zhou

et al. 2019

Clinical Laboratory Analysis

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Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease that involves T cell, B cell, and dendritic cell dysfunction, as well as antinuclear autoantibody production. 1 Several clinical and scientific studies of SLE indicate an increased risk of thrombosis in these cases. [2][3][4][5] Moreover, patients with SLE may exhibit accelerated atherosclerosis, and higher cardiovascular morbidity and mortality. 6The traditional parameters for screening coagulopathy include prothrombin time (PT) and activated partial thromboplastin time (aPTT). However, in Owaidah's study, among patients with positive lupus anticoagulant (LAC) status, 61% exhibited abnormal aPTT results that could not be corrected by mixing with normal plasma; moreover, the PT test yielded normal results in 90% cases. 7 However, there is a limitation of the aPTT and PT test in these cases, as the results may reflect a certain product in the coagulation process, rather than the actual marker they are intended to reflect. Moreover, SLE Abstract Background: Thromboelastography (TEG) can reflect the coagulation status in vivo, from clot formation to clot lysis. In the present study, we aimed to evaluate the function of TEG in detecting coagulation in patients with SLE and sought to explore the correlation between clinical and laboratory data. Methods:A total of 41 patients with new-onset SLE who had not undergone treatment and 56 healthy controls were included. TEG and other laboratory tests were performed, and clinical data were collected.Results: A significant difference in the TEG reaction time and TEG achievement of clot firmness was observed between the groups. Moreover, these parameters were correlated with the lupus anticoagulant levels, platelet count, 24-hour urinary total protein quantity, and systemic lupus erythematosus disease activity index. Conclusion:Our study demonstrated the prospective value of TEG in evaluating hypercoagulability in patients with SLE.

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“…Characterization of the donated blood should comprise whole blood haemogram data, analysis of markers of acute inflammation, e.g., C‐reactive protein levels as well as test for platelet function ( Table 2 ). At least six (in ideal cases ten) different donors should be included in each study for considering the interindividual variability. While the inclusion of apparently healthy human subjects into initial screening studies is important for achieving reproducible test results, studies at an advanced material/device development stage should also include in vitro test with blood from the designated patient group .…”

Section: Prerequisites For a Reproducible In Vitro Testingmentioning

confidence: 99%

In Vitro Thrombogenicity Testing of Biomaterials

Braune

Latour

Reinthaler

et al. 2019

Adv Healthcare Materials

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reliable, and reproducible. [20][21][22] This is, not least, important for realizing interstudy comparisons of the thrombogenicity of different materials. According, e.g., to the regulation (EU) 2017/745 of the European parliament and of the council on medical devices, in vitro and in vivo tests are a mandatory parts within the preclinical product verification and validation (see Annex II: Technical documentation, 6.1 Preclinical and clinical data). [23] Beyond the results of these tests, also detailed information concerning the test design, respective protocols and data analysis are obligatory to meet the requirements of the regulation, particularly those formulated in the ISO standard 10993 Part 4. [24,25] Since the regulatory agencies provide recommendations rather than protocols or standard operation procedures, accepted standardizations regarding the preanalytical handling of the blood, test conditions, test parameters, reference materials, static or dynamic conditions, flow conditions, and finally, which type of cells and donors should be included is lacking. Also, standard operating procedures how the testing should be performed are lacking. [9] This has led to a situation that laboratories perform in vitro assays under substantially different test conditions, including the preanalytical characterization of blood samples, the application of blood from different species, varying anticoagulation and stabilization or storage times as well as test setups. Taking these variations into account, interlaboratory or interstudy comparisons are impossible. [8,[26][27][28] Here, we review described test methods and procedures for the assessment of the thrombogenicity of materials, prerequisites for a reproducible in vitro testing, applied test system and test parameters for the characterization of the interaction of blood components/cells and the implant. We further review and outline recent approaches that may support realizing reliable, reproducible, and laboratory independent tests.

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Platelet Aggregometry Testing: Molecular Mechanisms, Techniques and Clinical Implications

Cited by 104 publications

References 150 publications

Effect of Cardiopulmonary Bypass Machine on the Platelet Function Testing.

Effect of Cardiopulmonary Bypass Machine on the Platelet Function Testing.

Evaluating hypercoagulability in new‐onset systemic lupus erythematosus patients using thromboelastography

In Vitro Thrombogenicity Testing of Biomaterials

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