Evaluation of the TEG® platelet mappingTM assay in blood donors

Louise Bochsen, Bo Wiinberg, Mads Jens Kjelgaard-Hansen, Daniel A. Steinbrüchel, Pär I. Johansson

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    Abstract

    Background

    Monitoring of antiplatelet therapy in patients at cardiovascular risk is difficult because existing platelet function tests are too sophisticated for clinical routine. The whole blood TEG® Platelet MappingTM assay measures clot strength as maximal amplitude (MA) and enables for quantification of platelet function, including the contribution of the adenosine diphosphate (ADP) and thromboxane A2 (TxA2) receptors to clot formation.

    Methods

    In 43 healthy blood donors, the analytical (CVa) and inter-individual variability (CVg) of the TEG® Platelet MappingTM assay were determined together with platelet receptor inhibition in response to arachidonic acid (AA) and ADP.

    Results

    The CVa of the assay for maximal platelet contribution to clot strength (MAThrombin) was 3.5%, for the fibrin contribution to clot strength (MAFibrin) 5.2%, for MAAA 4.5% and for MAADP it was 6.6%. The MAThrombin CVg was 2.8%, MAFibrin 4.7%, MAAA 6.6% and for MAADP it was 26.2%. Females had a higher MAThrombin compared to males (62.8 vs. 58.4 mm, p = 0.005). The platelet TxA2 receptor inhibition was 1.2% (range 0-10%) and lower than for the ADP receptor (18.6% (0-58%); p < 0.0001).

    Conclusion

    The high variability in ADP receptor inhibition may explain both the differences in response to ADP receptor inhibitor therapy and why major bleeding sometimes develops during surgery in patients not treated with ADP receptor inhibitors. An analytical variation of ~5 % for the TEG® enables, however, for routine monitoring of the variability in ADP receptor inhibition and of antiplatelet therapy.

    OriginalsprogEngelsk
    TidsskriftThrombosis Journal
    Vol/bind5
    Udgave nummer3
    Antal sider5
    ISSN1477-9560
    DOI
    StatusUdgivet - 2007

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