title: Utility of whole-blood aggregometry for evaluating anti-platelet therapy for Kawasaki disease.
abstract: BACKGROUND
  Anti-platelet therapy for Kawasaki disease (KD) is often done without monitoring drug efficacy. The aim of this study was to investigate the utility of whole-blood aggregometry to evaluate the efficacy of anti-platelet therapy for KD.
  
  
  METHODS
  Of 37 late-phase KD patients included in the present study, 20 were prescribed anti-platelet drugs. Platelet-rich plasma (PRP) aggregation with collagen as the stimulus was measured using an optical aggregometer. The area under the curve of small and large size aggregations was calculated, and categorized into five classes: -2, -1, 0, 1, and 2. Whole-blood aggregation with collagen or adenosine 5'-diphosphate (ADP) as stimulus was evaluated using the platelet aggregation threshold index (PATI), which is the concentration of stimulus that induces a whole-blood aggregation rate of 50%.
  
  
  RESULTS
  In both collagen- and ADP-induced aggregation, there was a negative correlation between PATI and class determination using the PRP technique (collagen, rs = -0.870, P < 0.0001; ADP, rs = -0.620, P < 0.0001). Moreover, the PATI in collagen- and ADP-induced aggregation was significantly higher in the anti-platelet drug therapy group than in the untreated group (collagen, P < 0.0001; ADP, P = 0.0002). The serum thromboxane B2 level in the anti-platelet drug therapy group was also significantly lower than that in the untreated group (P < 0.0001). PATI was significantly higher in those treated with thienopyridine drug combinations than those without drug therapy (P = 0.0036).
  
  
  CONCLUSIONS
  Whole-blood aggregometry is useful for monitoring the efficacy of anti-platelet therapy for KD.
authors: Departments of Pediatric Cardiology and Nephrology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan.
authors: Chinatsu
authors: C
authors: Suzuki
authors: Tomoyo
authors: T
authors: Yahata
authors: Akiko
authors: A
authors: Okamoto-Hamaoka
authors: Maiko
authors: M
authors: Fujii
authors: Ayako
authors: A
authors: Yoshioka
authors: Youko
authors: Y
authors: Niwa
authors: Kazuyuki
authors: K
authors: Ikeda
authors: Akihiro
authors: A
authors: Nakamura
authors: Kenji
authors: K
authors: Hamaoka
mesh_terms: D000293:Adolescent; D000328:Adult; D001792:Blood Platelets / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D016903:Drug Monitoring / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood* / Q000188:drug therapy; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D015203:Reproducibility of Results; D055815:Young Adult
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Kawasaki disease; anti-platelet therapy; drug compliance; platelet aggregation