Utility of the PFA-100 Instrument and the Novel Multiplate Analyzer for the Assessment of Aspirin and Clopidogrel Effects on Platelet Function in Patients With Cardiovascular Disease

Abstract

This study evaluated the utility of the PFA-100 and the Multiplate analyzer for the assessment of aspirin and clopidogrel effects on platelet function in patients with cardiovascular disease. Platelet function was determined with the PFA-100 using collagen+epinephrine (CEPI) and collagen+adenosine-5’-diphosphate (CADP) cartridges, and with whole blood impedance aggregometry using the Multiplate ASPI and ADP+PG tests (aggregation triggered with arachidonic acid and ADP+ prostaglandin E1, respectively). Four study groups were identified from the 154 patients enrolled: patients without antiplatelet therapy, patients with 100 mg aspirin daily but without clopidogrel treatment, patients with 75 mg clopidogrel daily but without aspirin treatment, and patients with both 100 mg aspirin daily plus 75 mg clopidogrel daily. It was found that the PFA-100 instrument is useful for detection of aspirin but not for detection of a clopidogrel effect, while the Multiplate analyzer is useful for specific detection of both aspirin and clopidogrel effects on platelet function.

Keywords

aggregometry aspirin cardiovascular disease clopidogrel drugs platelets thienopyridines

References

Maree AO , Fitzgerald DJ Variable platelet response to aspirin and clopidogrel in atherothrombotic disease. Circulation. 2007;115:2196-2207.

Wang TH , Bhatt DL , Topol EJ Aspirin and clopidogrel resistance: an emerging clinical entity. Eur Heart J. 2006;27:647-654.

Michelson AD , Frelinger AL 3rd , Furman MI Current options in platelet function testing . Am J Cardiol. 2006;98(10A):4N-10N.

Campbell CL , Steinhubl SR Variability in response to aspirin: do we understand the clinical relevance ? J Thromb Haemost. 2005;3:665-669.

Hankey GJ , Eikelboom JW Aspirin resistance. Lancet. 2006;367:606-617.

Wiviott SD

Clopidogrel response variability, resistance, or both?

Am J Cardiol. 2006;98(10A):18N-24N.

Gurbel PA , Tantry US Clopidogrel resistance? Thromb Res. 2007;120:311-321.

Harrison P. , Frelinger AL 3rd , Furman MI , Michelson AD Measuring antoplatelet drug effects in the laboratory. Thromb Res. 2007;120:323-36.

Francis JL The platelet function analyzer (PFA)-100. In: Michelson AD , ed. Platelets. 2nd ed. San Diego, CA: Elsevier/ Academic Press, 2006:519-534.

10.

Mueller T. , Haltmayer M. , Poelz W. , Haidinger D. Monitoring aspirin 100 mg and clopidogrel 75 mg therapy with the PFA-100 device in patients with peripheral arterial disease. Vasc Endovascular Surg. 2003;37: 117-123.

11.

Calatzis A. , Wittwer M. , Krueger B. A new approach to platelet function analysis in whole blood - the Multiplate analyzer. Platelets. 2004;15:485-486.

12.

Tóth O. , Calatzis A. , Penz S. , Losonczy H. , Siess W. Multiple electrode aggregometry: a new device to measure platelet aggregation in whole blood. Thromb Haemost . 2006;96:781-788.

13.

Mueller T. , Dieplinger B. , Poelz W. , Calatzis A. , Haltmayer M. Utility of whole blood impedance aggregometry for the assessment of clopidogrel action using the novel Multiplate analyzer - comparison with two flow cytometric methods. Thromb Res. 2007;121:249-258.

14.

von Pape KW , Dzijan-Horn M. , Bohner J. , Spannagl M. , Weisser H. , Calatzis A. Control of aspirin effect in chronic cardiovascular patients using two whole blood platelet function assays. PFA-100 and Multiplate . Hämostaseologie. 2007;27:155-160.

15.

Sibbing D. , Braun S. , Jawansky S. , Vogt W. , Mehilli J. , Schömig A. , Kastrati A. , von Beckerath N. Assessment of ADP-induced platelet aggregation with light transmission aggregometry and multiple electrode platelet aggregometry before and after clopidogrel treatment. Thromb Haemost. 2008;99:121-126.

16.

Linnemann B. , Rechner A. , Schwonberg J. , Mani H. , Lindhoff-Last E. Assessment of clopidogrel non-response in patients with peripheral arterial disease (PAD) by the platelet function analyzer (PFA-100) using an experimental P2Y cartridge. Hämostaseologie . 2008;28:A81.

17.

Rechner A. , Jakubowski JA , Sugidachi A. , Oehler C. , Zander N. The sensitivity of a new cartridge design for the PFA-100 system to inhibition of platelet function by the active metabolite of prasugrel (R-138727). Hämostaseologie. 2008;28:A84.

18.

Seyfert UT , Haubelt H. , Vogt A. , Hellstern P. Variables influencing Multiplate(TM) whole blood impedance platelet aggregometry and turbidimetric platelet aggregation in healthy individuals. Platelets. 2007;18:199-206.

19.

del Zoppo GJ Central nervous system ischemia. In: Michelson AD , ed. Platelets. 2nd ed. San Diego, CA: Elsevier/ Academic Press, 2006:657-683.

20.

Stratmann B. , Menart B. , Tschoepe D. Diabetes mellitus. In: Michelson AD , ed. Platelets. 2nd ed. San Diego, CA: Elsevier/Academic Press, 2006:697-711.