Precision and reliability of 5 platelet function tests in healthy volunteers and donors on daily antiplatelet agent therapy

Brad S. Karon, Nicole V. Tolan, Christopher D. Koch, Amy M. Wockenfus, Randall S. Miller, Ravi K. Lingineni, Rajiv K. Pruthi, Dong Chen, Allan S Jaffe

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Anticoagulation protocols used during mechanical circulatory support call for titration of antiplatelet agents. We compared the precision and reliability of 5 platelet function tests in healthy volunteers and donors on daily antiplatelet therapy to distinguish their efficacy for titrating antiplatelet therapy.

METHODS: We assessed arachidonic acid-induced platelet function by light transmission aggregometry (LTA), Multiplate impedance aggregometry, VerifyNow, and platelet mapping by thromboelastography (TEG PM). We assessed ADP-induced platelet function by the same methods and flow cytometry. Forty healthy volunteers and 10-13 volunteers on daily aspirin and/or clopidogrel therapy were evaluated. We compared tests for intraassay precision, interassay precision (samples from 2 separate blood draws), and reliability coefficient.

RESULTS: For arachidonic acid-induced platelet aggregation in healthy volunteers, intra- and interassay CVs were ≤ 10% for all methods. Intra- and interassay precision among donors on daily aspirin was ≤ 30% for all methods except LTA (38% interassay CV) and TEG PM (95% intraassay and 104% interassay CV). For ADP-induced platelet function, intra- and interassay precision was ≤ 10% and ≤ 30% for all methods. Only Multiplate demonstrated moderate or greater (R > 0.40) reliability coefficients for arachidonic acid-induced platelet function among all subjects. All methods of ADP-induced platelet function, except TEG PM, demonstrated substantial or greater (R > 0.60) reliability among all subjects.

CONCLUSIONS: TEG PM is least suited to monitor effects of antiplatelet agents. Multiplate impedance aggregometry was the only method to demonstrate an acceptable reliability coefficient among healthy volunteers and donors on both aspirin and clopidogrel therapy.

Original languageEnglish (US)
Pages (from-to)1524-1531
Number of pages8
JournalClinical Chemistry
Volume60
Issue number12
DOIs
StatePublished - Dec 1 2014

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Platelet Function Tests
Platelet Aggregation Inhibitors
Platelets
Healthy Volunteers
Blood Platelets
clopidogrel
Tissue Donors
Arachidonic Acid
Adenosine Diphosphate
Aspirin
Electric Impedance
Therapeutics
Light transmission
Thrombelastography
Light
Platelet Aggregation
Flow cytometry
Volunteers
Flow Cytometry
Titration

ASJC Scopus subject areas

  • Medicine(all)

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Precision and reliability of 5 platelet function tests in healthy volunteers and donors on daily antiplatelet agent therapy. / Karon, Brad S.; Tolan, Nicole V.; Koch, Christopher D.; Wockenfus, Amy M.; Miller, Randall S.; Lingineni, Ravi K.; Pruthi, Rajiv K.; Chen, Dong; Jaffe, Allan S.

In: Clinical Chemistry, Vol. 60, No. 12, 01.12.2014, p. 1524-1531.

Research output: Contribution to journalArticle

Karon, BS, Tolan, NV, Koch, CD, Wockenfus, AM, Miller, RS, Lingineni, RK, Pruthi, RK, Chen, D & Jaffe, AS 2014, 'Precision and reliability of 5 platelet function tests in healthy volunteers and donors on daily antiplatelet agent therapy', Clinical Chemistry, vol. 60, no. 12, pp. 1524-1531. https://doi.org/10.1373/clinchem.2014.226332
Karon, Brad S. ; Tolan, Nicole V. ; Koch, Christopher D. ; Wockenfus, Amy M. ; Miller, Randall S. ; Lingineni, Ravi K. ; Pruthi, Rajiv K. ; Chen, Dong ; Jaffe, Allan S. / Precision and reliability of 5 platelet function tests in healthy volunteers and donors on daily antiplatelet agent therapy. In: Clinical Chemistry. 2014 ; Vol. 60, No. 12. pp. 1524-1531.
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abstract = "BACKGROUND: Anticoagulation protocols used during mechanical circulatory support call for titration of antiplatelet agents. We compared the precision and reliability of 5 platelet function tests in healthy volunteers and donors on daily antiplatelet therapy to distinguish their efficacy for titrating antiplatelet therapy.METHODS: We assessed arachidonic acid-induced platelet function by light transmission aggregometry (LTA), Multiplate impedance aggregometry, VerifyNow, and platelet mapping by thromboelastography (TEG PM). We assessed ADP-induced platelet function by the same methods and flow cytometry. Forty healthy volunteers and 10-13 volunteers on daily aspirin and/or clopidogrel therapy were evaluated. We compared tests for intraassay precision, interassay precision (samples from 2 separate blood draws), and reliability coefficient.RESULTS: For arachidonic acid-induced platelet aggregation in healthy volunteers, intra- and interassay CVs were ≤ 10{\%} for all methods. Intra- and interassay precision among donors on daily aspirin was ≤ 30{\%} for all methods except LTA (38{\%} interassay CV) and TEG PM (95{\%} intraassay and 104{\%} interassay CV). For ADP-induced platelet function, intra- and interassay precision was ≤ 10{\%} and ≤ 30{\%} for all methods. Only Multiplate demonstrated moderate or greater (R > 0.40) reliability coefficients for arachidonic acid-induced platelet function among all subjects. All methods of ADP-induced platelet function, except TEG PM, demonstrated substantial or greater (R > 0.60) reliability among all subjects.CONCLUSIONS: TEG PM is least suited to monitor effects of antiplatelet agents. Multiplate impedance aggregometry was the only method to demonstrate an acceptable reliability coefficient among healthy volunteers and donors on both aspirin and clopidogrel therapy.",
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T1 - Precision and reliability of 5 platelet function tests in healthy volunteers and donors on daily antiplatelet agent therapy

AU - Karon, Brad S.

AU - Tolan, Nicole V.

AU - Koch, Christopher D.

AU - Wockenfus, Amy M.

AU - Miller, Randall S.

AU - Lingineni, Ravi K.

AU - Pruthi, Rajiv K.

AU - Chen, Dong

AU - Jaffe, Allan S

PY - 2014/12/1

Y1 - 2014/12/1

N2 - BACKGROUND: Anticoagulation protocols used during mechanical circulatory support call for titration of antiplatelet agents. We compared the precision and reliability of 5 platelet function tests in healthy volunteers and donors on daily antiplatelet therapy to distinguish their efficacy for titrating antiplatelet therapy.METHODS: We assessed arachidonic acid-induced platelet function by light transmission aggregometry (LTA), Multiplate impedance aggregometry, VerifyNow, and platelet mapping by thromboelastography (TEG PM). We assessed ADP-induced platelet function by the same methods and flow cytometry. Forty healthy volunteers and 10-13 volunteers on daily aspirin and/or clopidogrel therapy were evaluated. We compared tests for intraassay precision, interassay precision (samples from 2 separate blood draws), and reliability coefficient.RESULTS: For arachidonic acid-induced platelet aggregation in healthy volunteers, intra- and interassay CVs were ≤ 10% for all methods. Intra- and interassay precision among donors on daily aspirin was ≤ 30% for all methods except LTA (38% interassay CV) and TEG PM (95% intraassay and 104% interassay CV). For ADP-induced platelet function, intra- and interassay precision was ≤ 10% and ≤ 30% for all methods. Only Multiplate demonstrated moderate or greater (R > 0.40) reliability coefficients for arachidonic acid-induced platelet function among all subjects. All methods of ADP-induced platelet function, except TEG PM, demonstrated substantial or greater (R > 0.60) reliability among all subjects.CONCLUSIONS: TEG PM is least suited to monitor effects of antiplatelet agents. Multiplate impedance aggregometry was the only method to demonstrate an acceptable reliability coefficient among healthy volunteers and donors on both aspirin and clopidogrel therapy.

AB - BACKGROUND: Anticoagulation protocols used during mechanical circulatory support call for titration of antiplatelet agents. We compared the precision and reliability of 5 platelet function tests in healthy volunteers and donors on daily antiplatelet therapy to distinguish their efficacy for titrating antiplatelet therapy.METHODS: We assessed arachidonic acid-induced platelet function by light transmission aggregometry (LTA), Multiplate impedance aggregometry, VerifyNow, and platelet mapping by thromboelastography (TEG PM). We assessed ADP-induced platelet function by the same methods and flow cytometry. Forty healthy volunteers and 10-13 volunteers on daily aspirin and/or clopidogrel therapy were evaluated. We compared tests for intraassay precision, interassay precision (samples from 2 separate blood draws), and reliability coefficient.RESULTS: For arachidonic acid-induced platelet aggregation in healthy volunteers, intra- and interassay CVs were ≤ 10% for all methods. Intra- and interassay precision among donors on daily aspirin was ≤ 30% for all methods except LTA (38% interassay CV) and TEG PM (95% intraassay and 104% interassay CV). For ADP-induced platelet function, intra- and interassay precision was ≤ 10% and ≤ 30% for all methods. Only Multiplate demonstrated moderate or greater (R > 0.40) reliability coefficients for arachidonic acid-induced platelet function among all subjects. All methods of ADP-induced platelet function, except TEG PM, demonstrated substantial or greater (R > 0.60) reliability among all subjects.CONCLUSIONS: TEG PM is least suited to monitor effects of antiplatelet agents. Multiplate impedance aggregometry was the only method to demonstrate an acceptable reliability coefficient among healthy volunteers and donors on both aspirin and clopidogrel therapy.

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