Comparison of light transmission aggregometry and multiple electrode aggregometry for the evaluation of patients with mucocutaneous bleeding

2018 ◽  
Vol 41 (1) ◽  
pp. 133-140 ◽  
Author(s):  
Ping Sun ◽  
Eileen McMillan-Ward ◽  
Rajibul Mian ◽  
Sara J. Israels
Keyword(s):  
Light Transmission ◽  
Multiple Electrode Aggregometry ◽  
Light Transmission Aggregometry ◽  
Mucocutaneous Bleeding ◽  
Multiple Electrode

scholarly journals Έλεγχος με οπτική θολοσιμετρική συσσώρευση και multiplate της αιμοπεταλιακής απάντησης στην κλοπιδογρέλη στεφανιαίων ασθενών με σακχαρώδη διαβήτη τύπου ΙΙ υπό διπλή κλασική αντιαιμοπεταλιακή αγωγή και συσχέτιση του εργαστηριακού ευρήματος με την κλινική έκβαση

2020 ◽  
Author(s):  
Μαρία Τάιχερτ
Keyword(s):  
Odds Ratio ◽  
Light Transmission ◽  
Cohen’S Kappa ◽  
Multiple Electrode Aggregometry ◽  
Cohen's Kappa ◽  
Light Transmission Aggregometry ◽  
Multiple Electrode

Στόχος: Περιορισμένα ήταν τα διαθέσιμα δεδομένα σχετικά με την κλινική σημασία των μετρήσεων της λειτουργικότητας των αιμοπεταλίων σε σταθερούς ασθενείς με στεφανιαία νόσο (ΣΝ). Στόχος μας είναι να αξιολογήσουμε τη συμφωνία μεταξύ της Συσσωματομετρίας Σύνθετης Αντίστασης (Multiple Electrode Aggregometry, MEA και της Οπτικής Θολοσιμετρικής Συσσώρευσης (Light Transmission Aggregometry, LTA) στην ανίχνευση των ασθενών με χαμηλή απόκριση στην κλοπιδογρέλη και την προγνωστική τους αξία σε ασθενείς με ΣΝ και με σακχαρώδη διαβήτη τύπου 2 (ΣΔτ2) υπό διπλή αναστολή αιμοπεταλίων. Μέθοδοι: Η LTA και η ΜΕΑ πραγματοποιήθηκαν σε 122 σταθερούς καρδιαγγειακούς ασθενείς με ΣΔτ2. Ασθενείς με μετρήσεις LTAmax και MEA στο ανώτερο τεταρτημόριο ορίστηκαν ως χαμηλής απόκρισης στην κλοπιδογρέλη. Η συμφωνία μεταξύ των δύο μεθόδων αξιολογήθηκε με στατιστικά στοιχεία kappa. Εκτιμήσαμε την πιθανή συσχέτιση μεταξύ της ανταπόκρισης στην αντιαιμοπεταλιακή θεραπεία και την κλινική έκβαση. Επίσης, εκτιμήσαμε το βέλτιστο διαγνωστικό όριο σύμφωνα με την ανάλυση ROC για την πρόβλεψη της εμφάνισης αθηροθρομβωτικών επιπλοκών κατά τη διάρκεια της 1 έτους περιόδου παρακολούθησης. Αποτελέσματα: Οι συντελεστές Cohen’s kappa (0,214) έδειξαν μέτρια συμφωνία (70,2%) μεταξύ LTA και MEA. Συνολικά 25 MACE εμφανίστηκαν σε 108 ασθενείς (23,1%). Οι ασθενείς με MACE είχαν υψηλότερο LTAmax από αυτούς χωρίς (57,1 ± 16,5 έναντι 49,3 ± 18,3, αντίστοιχα, p = 0,023). Οι μετρήσεις ΜΕΑ ήταν παρόμοιες μεταξύ των ασθενών με και χωρίς MACE (30,1 ± 15,4 έναντι 30,6 ± 20,8, αντίστοιχα, p = 0,84). Η πολλαπλή λογιστική παλινδρόμηση έδειξε ότι οι μετρήσεις LTAmax αποτελούν ανεξάρτητο προγνωστικό παράγοντα θανάτου από καρδιαγγειακά αίτια (Odds Ratio, προσαρμοσμένες: 0,2, 0,05-0,81). Η ανάλυση ROC έδειξε ότι μια μέγιστη τιμή συσσωμάτωσης περίπου 62,5% φαίνεται να αποτελεί μια κρίσιμη μεταβλητή της κλινικής πρόγνωσης σε ασθενείς με ΣΔτ2 και ΣΝ (AUC = 0,67, ευαισθησία = 78%, εξειδίκευση = 61,5%). Συμπεράσματα: Η εκτίμηση της απόκρισης των αιμοπεταλίων παραμένει ιδιαίτερα εξειδικευμένη, με ανεπαρκή συμφωνία μεταξύ των δοκιμών. Τα αποτελέσματά μας υποστηρίζουν την εφαρμογή της LTA, αλλά όχι της MEA για την αξιολόγηση κινδύνου εμφάνισης MACE σε σταθερούς καρδιαγγειακούς ασθενείς με ΣΔτ2.

Assessment of ADP-induced platelet aggregation with light transmission aggregometry and multiple electrode platelet aggregometry before and after clopidogrel treatment

2008 ◽  
Vol 99 (01) ◽  
pp. 121-126 ◽  
Author(s):  
Siegmund Braun ◽  
Stefan Jawansky ◽  
Wolfgang Vogt ◽  
Julinda Mehilli ◽  
Albert Schömig ◽  
...  
Keyword(s):  
Platelet Aggregation ◽  
Platelet Function ◽  
Whole Blood ◽  
Light Transmission ◽  
Platelet Rich Plasma ◽  
Platelet Aggregometry ◽  
Light Transmission Aggregometry ◽  
Before And After ◽  
Standardized Method ◽  
Multiple Electrode

SummaryThe level of platelet aggregation, measured with light transmission aggregometry (LTA) in platelet rich plasma (PRP), has been shown to predict outcomes after percutaneous coronary intervention (PCI). However, measuring parameters of platelet function with LTA is time consuming and weakly standardized. Thus, a fast and standardized method to assess platelet function after clopidogrel treatment would be of great value for clinical practice. A new method, multiple electrode platelet aggregometry (MEA), to rapidly measure platelet aggregation in whole blood has recently been developed. The aim of this study was to assess parameters of platelet function with MEA and LTA before and after administration of 600 mg clopidogrel. Blood samples from 149 patients scheduled for coronary angiography were taken after clopidogrel treatment; in addition, in 60 of the patients samples were available before clopidogrel treatment. ADP-induced platelet aggregation was measured with LTA and simultaneously in whole blood with MEA on the Multiplate analyzer. Platelet aggregation measured with MEA decreased significantly after clopidogrel treatment (P<0.0001). ADP-induced platelet aggregation assessed with MEA and LTA correlated significantly (Spearman rank correlation coefficient=0.71; P<0.0001).The results of MEA, a fast and standardized method to assess the platelet response to ADP prior to and after clopidogrel treatment, correlate well with LTA.

Comparison of platelet aggregation using light transmission and multiple electrode aggregometry in Glanzmann thrombasthenia

Platelets ◽  
2009 ◽  
Vol 20 (5) ◽  
pp. 297-301 ◽  
Author(s):  
Abdalla Awidi ◽  
Ahmad Maqablah ◽  
Manar Dweik ◽  
Nazzal Bsoul ◽  
Ahmad Abu-Khader
Keyword(s):  
Platelet Aggregation ◽  
Light Transmission ◽  
Glanzmann Thrombasthenia ◽  
Multiple Electrode Aggregometry ◽  
Multiple Electrode

scholarly journals Comparison of Light Transmission Aggregometry With Impedance Aggregometry in Patients on Potent P2Y12 Inhibitors

2020 ◽  
pp. 107424842096870
Author(s):  
Patricia P. Wadowski ◽  
Joseph Pultar ◽  
Constantin Weikert ◽  
Beate Eichelberger ◽  
Irene M. Lang ◽  
...  
Keyword(s):  
Platelet Aggregation ◽  
Light Transmission ◽  
Platelet Reactivity ◽  
Adenosine Diphosphate ◽  
P2y12 Inhibitors ◽  
Coronary Syndrome ◽  
Multiple Electrode Aggregometry ◽  
Impedance Aggregometry ◽  
Light Transmission Aggregometry ◽  
Sensitivity Specificity

Since data on the agreement between light transmission aggregometry (LTA) and multiple electrode aggregometry (MEA) in patients on the more potent P2Y12 inhibitors are missing so far, we investigated if the evaluation of the responsiveness to therapy by LTA can be replaced by MEA in 160 acute coronary syndrome (ACS) patients on dual antiplatelet therapy with aspirin and prasugrel or ticagrelor (n = 80 each). Cut-off values for high on-treatment residual platelet reactivity (HRPR) in response to adenosine diphosphate (ADP) or arachidonic acid (AA) were defined according to previous studies showing an association of HRPR with the occurrence of adverse ischemic outcomes. ADP- inducible platelet aggregation was 33% and 37% (p = 0.07) by LTA and 19 AU and 20 AU (p = 0.38) by MEA in prasugrel- and ticagrelor-treated patients, respectively. AA- inducible platelet aggregation was 2% and 3% by LTA and 15 AU and 16 AU by MEA, (all p ≥ 0.3) in patients on prasugrel and ticagrelor, respectively. By LTA, HRPR ADP and HRPR AA were seen in 5%/5% and in 4%/ 13% of patients receiving prasugrel- and ticagrelor, respectively. By MEA, HRPR ADP and HRPR AA were seen in 3%/ 25% and 0%/24% of prasugrel- and ticagrelor-treated patients, respectively. ADP-inducible platelet reactivity by MEA correlated significantly with LTA ADP in prasugrel-treated patients (r = 0.4, p < 0.001), but not in those receiving ticagrelor (r = 0.09, p = 0.45). AA-inducible platelet aggregation by LTA and MEA did not correlate in prasugrel- and ticagrelor-treated patients. Sensitivity/specificity of HRPR by MEA to detect HRPR by LTA were 25%/99% for MEA ADP and 100%/79% for MEA AA in prasugrel-treated patients, and 0%/100% for MEA ADP and 70%/83% for MEA AA in ticagrelor-treated patients. In conclusion, on-treatment residual ADP-inducible platelet reactivity by LTA and MEA shows a significant correlation in prasugrel- but not ticagrelor-treated patients. However, in both groups LTA and MEA revealed heterogeneous results regarding the classification of patients as responders or non-responders to P2Y12 inhibition.

Inter-individual variability in clopidogrel inhibition effect on platelet aggregation

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Hussein Ali Sahib ◽  
Bassim Irhiem Mohammed ◽  
Ban A. Abdul Majid
Keyword(s):  
Cardiovascular Disease ◽  
Platelet Aggregation ◽  
Coronary Care Unit ◽  
Light Transmission ◽  
Individual Variability ◽  
Study Group ◽  
Inhibition Effect ◽  
Light Transmission Aggregometry ◽  
Coronary Care ◽  
Skewness And Kurtosis

Despite the unmistakable beneficial effect of clopidogrel on platelet aggregation,still there are some patient poorly responds to clopidogrel that may lead to worse cardiovascular clinical events.One hundred and twenty seven patients with cardiovascular disease (ACS,stroke,or TIA) were enrolled as a study group. Patients were recruited at coronary care unit (CCU) of Al-Yarmouk Teaching Hospital. Paletlet assessment was done by using light transmission aggregometry. between the patients that enrolled in this study there are significant inter-individual variability both skewness and Kurtosis were negative (-0.450,-0.130) respectively. 24% of patient enrolled in this study were hyporesponder.

Malondialdehyde Assay in the Evaluation of Aspirin Antiplatelet Effects

Pharmacology ◽  
2018 ◽  
Vol 103 (1-2) ◽  
pp. 23-29 ◽  
Author(s):  
Amin Polzin ◽  
Lisa Dannenberg ◽  
Theresa Schneider ◽  
Betül Knoop ◽  
David Naguib ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Operating Characteristic ◽  
Light Transmission ◽  
Platelet Reactivity ◽  
Area Under The Curve ◽  
Healthy Individuals ◽  
Antibody Assay ◽  
Light Transmission Aggregometry ◽  
Artery Disease

Aspirin is essential in secondary prevention of patients after myocardial infarction and with coronary artery disease. However, impaired pharmacodynamic response to aspirin is frequent (high on-treatment platelet reactivity [HTPR]). This leads to an enhanced prevalence of cardiovascular events and to an impaired clinical outcome. The current specific assays to evaluate aspirin antiplatelet effects are complex, time-consuming and demand for a high laboratory expertise. Therefore, we developed a potentially bedside assay based on the determination of malondialdehyde (MDA). MDA is a by-product of the thromboxane (TX) formation, which is synthesized in equimolar concentrations. In this study, we compared this MDA assay to the conventional assays in determination of pharmacodynamic aspirin response. For this, aspirin antiplatelet effects were measured in 22 healthy individuals and 63 aspirin treated patients using TX B2 formation enzyme-linked antibody assay, arachidonic acid induced light transmission aggregometry (LTA) and the new fluorometric MDA assay. In patients, MDA levels correlated well with TX formation (R = 0.81; 95% CI 0.69–0.88; p < 0.001) and LTA (R = 0.84; CI 0.74–0.91; p < 0.001). Receiver operating characteristic analyses revealed that the MDA assay does detect HTPR to aspirin sufficiently (area under the curve: 0.965; p < 0.001). The optimal cut-off was > 128 nmol/L (sensitivity of 100%, specificity of 91%). The new MDA assay is reliable in detecting HTPR. It is highly specific in the evaluation of antiplatelet effects by aspirin. This promising and potential bedside assay needs to be evaluated in clinical practice.

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