Multiplate

"Patients undergoing HD exhibit altered platelet function, indicated by reduced aggregation and platelet counts, as well as an association with systemic inflammation. Multiple electrode impedance aggregometry appears to be a feasible method for detecting platelet function alterations in patients receiving HD treatment. Responsiveness to NO donors was preserved in patients undergoing HD. Further studies are needed to identify the underlying mechanisms, particularly the role of NO signaling in platelet dysfunction in patients undergoing HD."

"This is the first study to systematically compare multiple next generation VET and platelet aggregation systems in both healthy and septic patients under controlled PTS transport conditions. It is hypothesized that PTS-induced acceleration may alter test results. Identifying a critical threshold could ensure safe, rapid blood transport without compromising diagnostic quality, potentially reducing personnel needs and expediting therapy initiation."

"Study findings support platelet function analysis by lumiaggregometry in women with refractory HMB requiring surgery. Accurate diagnosis would allow targeted haemostatic therapy and implementation of additional perioperative safety measures if surgery is still required."

"The use of platelet function monitoring makes it possible to determine the therapeutic effectiveness of P2Y12 inhibitors, and thus to provide the most appropriate antiplatelets treatment for the patient when an intracranial stent is placed."

"One in four eCAS patients were clopidogrel non-responders. This study suggests that personalized antiplatelet treatment therapy was safe, and that changing treatment to ticagrelor in clopidogrel non-responders was associated with better outcomes in eCAS patients."

"Caution must be exercised when extrapolating findings between assays, and the use of standard ranges must be medication-specific and sex-specific at a minimum. Researchers should also consider preanalytical and technical variables when designing experiments and interpreting platelet reactivity measures."

"Platelet aggregation and F1 + 2 were substantially elevated immediately after exercise in CAD patients, indicating a pro-thrombotic state. After 2 h of recovery, they exhibited a markedly increase in fibrinolysis. Similar results were observed in healthy individuals."

"Ticagrelor-related dyspnea was found to be related to low platelet aggregation, increased plasma creatinine concentration, decreased GFR, and ABCB1 T allele. Carriers of the ABCB1 T allele had a higher plasma creatinine concentration that could be associated with an inhibitory effect of ticagrelor on P-glycoprotein function."

"PFTs can play a crucial role in detecting resistance and non-sensitivity to antiplatelet drugs in patients with PAD post-revascularization. However, heterogeneity of data and methods underlines the need for standardized protocols and consensus-building among PFTs. Enhancing clinical utility and reliability could help optimize antiplatelet thromboprophylaxis, minimize thrombotic complications, and improve treatment strategies in vascular surgery. Further research is necessary to solidify the role of PFTs in guiding antiplatelet therapy post-revascularization in patients with PAD."

"Cilostazol in addition to standard DAPT reduces the incidence of HRPR and diminishes further platelet activity in poststent patients. Whether this favorable laboratory finding will affect clinical outcomes requires an adequately powered randomized trial."

"Modern hemostatic management and perioperative antiplatelet therapy (APT) administration/discontinuation management should be guided by thromboelastometry and platelet function testing. Prospective interventional trials are necessary to validate such an approach in multicentric studies."

"PD data [light transmittance aggregometry (LTA) (20- and 5-μM adenosine diphosphate [ADP] stimuli); VerifyNow P2Y12-test; Multiplate electrode aggregometry (MEA), ADP-test] show that in contemporary real-world STEMI patients pretreated within 1 h with ticagrelor undergoing primary PCI, adding cangrelor resulted in fast and potent platelet inhibition, thus suggesting that cangrelor may bridge the gap until ticagrelor reaches its effect."

"QUANTRA PCS, ROTEM A10 PC, and Multiplate ADPtest showed a significant decrease after CPB, whereas ROTEM PC and Multiplate TRAPtest did not. Major bleeding was predicted with a moderate to good discrimination by the post-CPB viscoelastic tests (PCS, PC, and A10 PC)."

"This study showed that Rotem, but not Multiplate results, were associated with platelet transfusion in pediatric cardiac surgery with no intake of platelet inhibitors. The usefulness of combining these tests in platelet transfusion decision-making needs to be evaluated in larger populations."

"Whole blood coagulation tests identified a more post-operative hypercoagulable state in patients who underwent OT compared to that of patients who underwent VATS. Larger studies are warranted to corroborate our results and assess their relevance in predicting thrombotic complications."

"The addition of PGE1 to the Multiplate ADP assay, and the correction for the difference in baseline platelet reactivity as measured by the Multiplate and VerifyNow, did not improve the correlation between the Multiplate ADP and VerifyNow P2Y12 assay in patients on DAPT. It is therefore unlikely that these factors explain a substantial part of the discrepancy between the tests."

Currently, no platelet function test (PFT) perfectly monitors clopidogrel efficacy. While VerifyNow P2Y12 is the most suitable point-of-care option and ROTEM shows promise, further prospective studies are essential. An ideal assay should utilize non-anticoagulated whole blood under high shear rates to accurately reflect in vivo thrombus stability. Furthermore, while CYP2C19 testing is not recommended for guiding therapy, combining PFT with HPLC drug-level monitoring would significantly improve our understanding of patient responsiveness and clinical outcomes.

"In this study, results from the analyzers TEG®6s and Multiplate® could be correlated but not with those from VerifyNow®. Significant differences of repeatability and consistency of results were found between the different analyzers and the clinical impact of these differences in patient outcomes need to be further investigated in clinical trials. Despite the collaborative analysis attempt towards clinical validation of standardized cut-off points for platelet function testing [3], there is a need to systematically develop standardized cut-off values for these platelet function analyzers in order to find the optimal range of platelet reactivity with validation in a randomized controlled trial enabling personalized antiplatelet therapy."

"A comparison of the difference in change of SA concentration between the day before surgery with day 1 and day 2 showed a significantly reduced increase in SA plasma levels after intake of aspirin at day 1 and day 2 after surgery (P < .0001), including a significantly reduced SA increase in the subgroup at 2, 3, and 4 hours after intake of aspirin. Corresponding with a reduced effect of aspirin, neither Multiplate Analyzer arachidonic acid, nor VerifyNow Aspirin Test showed a significant reduction in platelet aggregation 1 hour after intake of aspirin at day 1 (P < .0001). This also accounted for the subgroup 2, 3, and 4 hours after aspirin intake on day 1. At day 2 the same pattern as preoperatively was detected. After CABG, the SA level and the effect of aspirin were reduced in the immediate postoperative period."

"Because the ADP test was independently associated with perioperative stroke/TIA, the assessment of platelet reactivity using Multiplate may offer potential utility in monitoring patients undergoing CEA."

"Multiple electrode aggregometry produces consistent results of ADP-induced platelet aggregation independent of the time from blood draw to measurement within 30–180 min. Although other studies observed decreasing platelet aggregation over time in healthy volunteers, this study suggests that time from blood draw to multiple electrode aggregometry does not impact platelet aggregation results for potential clinical decision making in patients receiving clopidogrel."

"Platelet reactivity, assessed by P-selectin expression measured directly after surgery is associated with PMI, assessed by elevated cTn concentrations in the early postoperative period in patients undergoing elective open abdominal aortic surgery."

"In the Chinese patients with CHD who participated in this study, 46% showed evidence of aspirin resistance by the Multiplate® Analyzer ASPI test 24 h after the last dose of aspirin and 27% showed aspirin resistance at 1 h post dose. The measurements of serum TXB2 did not correlate well with the ASPI test and are unlikely to be useful in identifying patients with aspirin resistance. Aspirin resistance was not associated with having DM in this study but did show associations with WBC count, Hct, platelet count, smoking history and heart rate. The WBC count showed the strongest association with aspirin resistance with a cut-off of about 7 × 109/L, which is within the normal range. Smoking history was another important factor associated with reduced aspirin effect."

"Acidemia caused by the addition of lactic acid to equine whole blood was associated with a mild though statistically significant decrease in platelet aggregation. In conjunction with other factors, this change may contribute to morbidity-related disorders of hemostasis, although its precise clinical relevance is uncertain."

"The Bruton's Tyrosine Kinase inhibitors, Ibrutinib and ONO-4059, show further inhibition of platelet aggregation in blood samples from patients with acute myocardial infarction, receiving dual antiplatelet therapy in a dose dependent manner. These results provide a rationale for Bruton's Tyrosine Kinase inhibitors to be tested as a potential new antiplatelet strategy for acute myocardial infarction."