A new point-of-care method for monitoring anti-platelet therapy: application of the cone and plate(let) analyzer.
Recent studies suggest that anti-platelet agents are not equally effective in all individuals. We have developed a new method to evaluate the effect of anti-platelet drugs using the cone and plate(let) analyzer (CPA) test. The method is based on the ability of activators to reduce platelet adhesion under flow conditions. Treatment of a blood sample with arachidonic acid (AA) or ADP in vitro significantly decreased platelet deposition to a surface coverage (SC) of 2.1+/-0.4 and 1.3+/-0.6%, respectively, compared with the basic SC of 12.3+/-6.8%. The effect of AA was prevented by aspirin (SC 8.1+/-3.8%) and that of ADP was reduced by 2-methylthio-AMP, a P2Y12 ADP receptor inhibitor (SC 4.8+/-2.0%). Pre-incubation with AA of whole blood samples from untreated healthy volunteers resulted in a marked decline of SC (from SC 9.8+/-2.2 to 0.6+/-0.3%). In contrast, in volunteers treated with 100, 300, and 500 mg aspirin per day, AA (but not ADP) decreased SC only to 3.5+/-1.3, 4.4+/-1.7, and 4.1+/-2.0%, respectively (P<0.001 versus SC with AA before treatment). A good correlation was observed between the modified CPA and aggregometry (R2=0.55). In conclusion, the modified CPA test is a useful tool to evaluate the efficacy of anti-platelet therapy.
Spectre
Galia
G
Coagulation Unit, Hematology Department, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Brill
Alexander
A
Gural
Alexander
A
Shenkman
Boris
B
Touretsky
Natalia
N
Mosseri
Elinor
E
Savion
Naphtali
N
Varon
David
D
D000244:Adenosine Diphosphate / Q000494:pharmacology; D000328:Adult; D016718:Arachidonic Acid / Q000494:pharmacology; D001241:Aspirin / Q000097:blood / Q000494:pharmacology; D001798:Blood Proteins / Q000494:pharmacology; D016903:Drug Monitoring / Q000379:methods*; D006801:Humans; D008565:Membrane Proteins / Q000037:antagonists & inhibitors / Q000097:blood / Q000494:pharmacology; D010973:Platelet Adhesiveness / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology*; D010979:Platelet Function Tests / Q000295:instrumentation / Q000379:methods*; D019095:Point-of-Care Systems; D058919:Purinergic P2 Receptor Antagonists; D018048:Receptors, Purinergic P2 / Q000097:blood; D058925:Receptors, Purinergic P2Y12; D012680:Sensitivity and Specificity
D001798:Blood Proteins; D008565:Membrane Proteins; C548576:P2RY12 protein, human; D010975:Platelet Aggregation Inhibitors; D058919:Purinergic P2 Receptor Antagonists; D018048:Receptors, Purinergic P2; D058925:Receptors, Purinergic P2Y12; C024875:platelet adhesion inhibitor; D016718:Arachidonic Acid; D000244:Adenosine Diphosphate; D001241:Aspirin