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16. Whole Blood Platelet function Assay on the /CHORTMPoint-of-Care Hematology Analyzer

Author

Carville, David G.M., Schleckser, Patricia A., Guyer, Kirk E., Corsello, Michael, Walsh, Mark M., Carville, David G.M., Schleckser, Patricia A., Guyer, Kirk E., Corsello, Michael, and Walsh, Mark M.

Abstract

The role of platelets as the initial defense against insult to the vasculature is well established. Moreover, platelets are now recognized as having a critical role in the acute care settings of cardiopulmonary bypass (CPB) procedures and cardiac catheterization. In the environment of CPB, both platelet count and function have been demonstrated as being markedly compromised during and following the procedure. Unfortunately, current assays that are used to evaluate the parameters of platelet count and function are limited in regard to their utility in a near patient format. Here, we describe a practical, rapid, and user-friendly whole blood platelet function assay that has been developed for the ICHOR™ point-of-care hematology analyzer. This analyzer is capable of performing an eight parameter blood profile including platelet count. In comparable studies, platelet aggregation in whole blood demonstrated good correlation (for ADP the values were n=14, r2=0.81, p=0.0001; for collagen, n=10, r2=0.93, p=0.0001; for ristocetin, n=10, r2=0.89, p=0.0001; and for epinephrine, n=10, r2=0.81, p=0.0003) with traditional platelet-rich aggregometry, which uses increased light transmission as an indication of platelet aggregation. Furthermore, early feasibility studies in CPB patients demonstrated both decreased platelet count and a marked reduction in platelet function peri-procedurally. This new assay of platelet function is extremely suitable for the clinical environment with rapid turnaround time and provides a full hematology profile to enhance transfusion decisions.

Published
1998
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17. AspirinWorks.

Author

Geske, F. Jon, Guyer, Kirk E., and Ens, Gordon

Subjects
*ENZYME-linked immunosorbent assay, *PHARMACODYNAMICS, *ASPIRIN, *DRUG dosage, *ANTICOAGULANTS, *CARDIOVASCULAR disease treatment, *THROMBOSIS, *CYCLOOXYGENASES, *THROMBOXANES
Abstract

• Atherothrombosis, the major cause of acute coronary syndromes, remains the world's leading cause of morbidity and mortality. Platelets are central to the process of atherothrombosis and, therefore, antiplatelet therapies have been widely advocated in managing this disorder. • Low-dose aspirin (acetylsalicylic acid) is commonly prescribed as an antiplatelet therapy for secondary prevention of serious ischemic events. However, recent reports suggest that not all patients respond to low-dose aspirin to the same degree. Conservative estimates of aspirin nonresponsiveness (also known as 'aspirin resistance') range from 5 to 25%, depending on the testing platform and clinical status of the tested patient population. • The prevalence of aspirin resistance suggests a need for a test to monitor aspirin response in the individual patient. Such a test would allow for individualized treatment rather than treatment of the disease on a population basis. • Historical methods to assess the effect of aspirin on platelet function involve ex vivo platelet aggregation techniques that are not conducive to mass screening of individuals. • Aspirin exerts its antiplatelet effect through inhibition of the platelet cyclooxygenase (COX) pathway and subsequent reduction in thromboxane A2 (TxA2) production. Assessment of the adequacy of COX-1 pathway inhibition by aspirin can be performed by measuring levels of 11-dehydrothromboxane B2 (11dhTxB2), a stable metabolite of TxA2. • AspirinWorks® is an FDA cleared competitive immunoassay in microplate format that measures levels of 11dhTxB2 in urine specimens. This test may be used by physicians to monitor aspirin effect and assist in optimizing antiplatelet therapy in individual patients. [ABSTRACT FROM AUTHOR]

Published
2008

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