Testing platelet activation with a shear-dependent platelet function test versus aggregation-based tests. Relevance for monitoring long-term glycoprotein IIb/IIIa inhibition

Julio I. Osende, Valentin Fuster, Eli I. Lev, Daichi Shimbo, Ursula Rauch, Jonathan D. Marmur, Merwin Richard, David Varon, Juan Jose Badimon

Research output: Contribution to journalArticlepeer-review

57 Scopus citations

Abstract

Background - Tests developed to monitor glycoprotein (GP) IIb/IIIa blockade do not properly reflect platelet function in vivo and need a baseline (pretreatment) value. Because GP IIb/IIIa is essential in platelet aggregation and thrombosis under shear conditions, a flow-dependent approach to monitor its inhibition can be used. Methods and Results - We compared a test based on flow-dependent platelet deposition, the Cone and Platelet Analyzer (CPA), with in vitro platelet aggregometry and the Rapid Platelet Function Assay (RPFA) on platelet function after GP IIb/IIIa inhibition. In vitro, increasing concentrations of abciximab (0% to 100% receptor occupancy) were tested. Ex vivo, platelet function was monitored with the CPA and with aggregometry for up to 1 week after abciximab administration. The CPA was better correlated with the percentage of free GP IIb/IIIa receptors than was aggregometry or the RPFA. Only the RPFA, when expressed as a ratio over baseline (pretreatment), was comparable to the CPA. Ex vivo, the CPA, but not aggregometry, showed prolonged platelet inhibition with gradual recovery from GP IIb/IIIa receptor blockade in the first week after abciximab administration. Conclusions - Platelet function assessment by shear-induced deposition is a reliable test to monitor a wide range of GP IIb/IIIa inhibition. Its accuracy does not require a baseline reference. The effects of GP IIb/IIIa blockade on platelet function should be examined under high shear conditions.

Original languageEnglish
Pages (from-to)1488-1491
Number of pages4
JournalCirculation
Volume103
Issue number11
DOIs
StatePublished - 20 Mar 2001
Externally publishedYes

Keywords

  • Drugs
  • Platelets
  • Tests

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