My NCBISign In

Display Settings:

Format

Send to:

Choose Destination

    J Lab Clin Med. 2004 May;143(5):301-9.

    A novel modification of the Thrombelastograph assay, isolating platelet function, correlates with optical platelet aggregation.

    Craft RM, Chavez JJ, Bresee SJ, Wortham DC, Cohen E, Carroll RC.

    Department of Anesthesiology and Medicine, University of Tenessee Graduate School of Medicine, Knoxville, TN 37920. USA.

    Flow cytometry, singlet platelet counting, and optical aggregation have been used to monitor clopidogrel and glycoprotein IIb/IIIa (GPIIb/IIIa) platelet antagonists. Optical aggregation is considered the gold standard, but neither it nor flow cytometry is convenient in larger-scale clinical studies or point-of-care systems. Singlet platelet counting, a point-of-care assay correlated with optical platelet aggregation, only provides a measurement of platelet function at a single point in time. The Thrombelastograph is used to assay whole blood for thrombin-generated maximal clot-shear elasticity, referred to as the maximal amplitude (MA). Although platelet dysfunction, thrombocytopenia, and the in vitro effect of strong inhibitors such as IIb/IIIa antagonists can be observed, with thrombin generation milder platelet inhibitors cannot be assessed. We modified the Thromboelastograph assay, using reptilase and factor XIIIa, to form a clot, without thrombin generation, in heparinized whole blood. The resulting clot MA is dependent on added platelet agonists such as ADP or arachidonic acid, is sensitive to platelet antagonists, and provides a continuous measure of platelet function more analogous and better correlated with optical aggregation. This novel modification of the Thromboelastograph assay should prove to be a useful point-of-care whole-blood assay with which to monitor the effects of GPIIb/IIIa, ADP, and thromboxane A(2)-receptor-inhibiting drugs in patients.

    PMID: 15122174 [PubMed - indexed for MEDLINE]

    Supplemental Content

    Click here to read
    Write to the Help Desk