title: Reference range determination for whole-blood platelet aggregation using the Multiplate analyzer.
abstract: OBJECTIVE
  To develop reference ranges for platelet aggregation using the Multiplate analyzer (Roche Diagnostics, Mannheim, Germany) in blood anticoagulated with sodium citrate (Na-citrate), lithium heparin (Li-heparin), or hirudin.
  
  
  METHODS
  The study was performed at three sites on consented, healthy adults (n = 193) not taking antiplatelet medication. Platelet aggregation was evaluated in response to adenosine-5'-diphosphate, arachidonic acid, collagen, thrombin receptor activating peptide, ristocetin, and adenosine-5'-diphosphate combined with prostaglandin E1. Precision testing was conducted using healthy donors and donors taking aspirin.
  
  
  RESULTS
  Whole-blood platelet aggregation showed anticoagulant-dependent differences in platelet responses to all agonists. Samples collected in Na-citrate demonstrated the lowest responses to all agonists. The highest responses were obtained using Li-heparin. Precision testing revealed high variability in platelet aggregation at lower agonist doses, regardless of anticoagulant. Highest platelet response variations occurred in response to arachidonic acid in blood anticoagulated with hirudin from participants taking aspirin.
  
  
  CONCLUSIONS
  These data demonstrate the importance of establishing locally relevant reference ranges.
authors.affiliation: From the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical Center, New York, NY; peersche@mskcc.org.
authors.forename: Ellinor I B
authors.initials: EI
authors.lastname: Peerschke
authors.affiliation: Roche Diagnostics, Indianapolis, IN;
authors.forename: Donna D
authors.initials: DD
authors.lastname: Castellone
authors.affiliation: Academic Medical Center, Amsterdam, The Netherlands; and.
authors.forename: A K
authors.initials: AK
authors.lastname: Stroobants
authors.affiliation: Florida Hospital, Orlando, FL.
authors.forename: John
authors.initials: J
authors.lastname: Francis
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000494:pharmacology; D001792:Blood Platelets / Q000166:cytology* / Q000187:drug effects; D002951:Citrates / Q000494:pharmacology; D005260:Female; D006493:Heparin / Q000494:pharmacology; D006629:Hirudins / Q000494:pharmacology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology; D010979:Platelet Function Tests / Q000295:instrumentation* / Q000592:standards; D012015:Reference Standards; D012016:Reference Values; D000077559:Sodium Citrate; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D002951:Citrates; D006629:Hirudins; D010975:Platelet Aggregation Inhibitors; D000077559:Sodium Citrate; D006493:Heparin
keywords: Aggregation; Anticoagulants; Multiplate; Platelets; Precision; Reference range