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Kenneth E Remy, Mark H Yazer, Arun Saini, Ajlana Mehanovic-Varmaz, Sharon R Rogers, Col Andrew P Cap, Philip C Spinella
BACKGROUND: Agitation of platelet units stored at room temperature is performed routinely to maintain platelet function and leukoreduction of blood products is standard of care in many countries to reduce immune consequences of transfusion. The effect of agitation and leukoreduction on whole blood stored at 4° C requires investigation as reductions in hemostatic capacity of whole blood may reduce its efficacy in treating trauma-induced coagulopathy and platelet dysfunction. We hypothesize that agitation of whole blood will not affect hemostatic function and that leukoreduction will reduce hemostatic function of whole blood...
March 16, 2018: Journal of Trauma and Acute Care Surgery
Katrine Munk Begtrup, Johanne Andersen Hojbjerg, Birgitte Vrou Offersen, Anne-Mette Hvas
Cancer is associated with increased risk of venous thromboembolic disease. Venous thromboembolic disease accounts for a substantial addition to morbidity and mortality rates in cancer patients and is the second leading cause of death in cancer patients, exceeded only by the underlying cancer. Only few previous studies have investigated the influence of radiotherapy on hemostasis and whether radiotherapy in itself causes an increased risk of venous thromboembolic disease. The aim was to investigate if adjuvant radiotherapy affects hemostasis after surgery and chemotherapy in patients with breast cancer...
March 19, 2018: Platelets
Masanori Tsujimoto, Yukiko Enomoto, Masafumi Miyai, Yusuke Egashira, Toru Iwama
Purpose To determine the best platelet function test for in-stent tissue protrusion following carotid artery stenting (CAS). Methods Patients who underwent CAS were recruited prospectively in this observational study. Combination of aspirin 100 mg/day and clopidogrel 75 mg/day was administered for a minimum of 7 days prior to procedure. Platelet aggregation was measured by light transmittance aggregometry (LTA) following stimulation by adenosine diphosphate (ADP), collagen, and thrombin receptor activating peptide (TRAP) and by the point of care assay, VerifyNow which measures aspirin and thienopyridine reaction units...
January 1, 2018: Journal of International Medical Research
Melissa V Chan, Paul C Armstrong, Timothy D Warner
While there are many bench and bedside tests to assess platelet reactivity, ex vivo light transmission aggregometry (LTA) remains the gold standard. LTA, however, is expensive, time-consuming and requires dedicated equipment and staff, making it impractical in many situations. In addition, there is significant variability between data generated at different testing sites meaning that tests often need to be repeated if a patient is transferred to the care of a different hospital. As such, there is clearly an unmet need for standardization of platelet testing...
March 15, 2018: Platelets
GianMarco Podda, Mariangela Scavone, Eti Alessandra Femia, Marco Cattaneo
A variety of laboratory tests have been developed, which can diagnose a number of both congenital and acquired disorders of platelet function. Many tests of platelet function measure the ability of platelets to adhere to each other, forming platelet aggregates, which represent the major constituents of hemostatic plugs and of arterial thrombi. Light transmission aggregometry (LTA) is still considered the gold standard of platelet aggregation tests, but other platelet aggregation-based tests are also available...
March 14, 2018: Platelets
Jacek Staszewski, Renata Piusińska-Macoch, Ewa Skrobowska, Bogdan Brodacki, Katarzyna Macek, Adam Stępień
BACKGROUND: The clinical significance of aspirin resistance (AR) in patients with symptomatic cerebrovascular disease is not well known. The aim of this single-center, prospective study was to examine the prevalence, risk factors and prognostic significance of AR in patients with different clinical manifestations of cerebral small vessel disease (CSVD) over 24-month follow-up. METHODS: We studied 104 patients with MRI confirmed CSVD, including those with recent lacunar stroke (LS, n=49), vascular parkinsonism (VaP, n=16) and dementia (VaD, n=39)...
January 2018: Annals of Clinical and Laboratory Science
Francesco Franchi, Fabiana Rollini, Jose Rivas Rios, Andrea Rivas, Malhar Agarwal, Megha Kureti, Deepa Nagaraju, Mustafa Wali, Zubair Shaikh, Maryuri Briceno, Ahmed Nawaz, Jae Youn Moon, Latonya Been, Siva Suryadevara, Daniel Soffer, Martin M Zenni, Theodore A Bass, Dominick J Angiolillo
BACKGROUND : Switching between different classes of P2Y12 inhibitors, including de-escalation from ticagrelor to clopidogrel, commonly occurs in clinical practice. However, the pharmacodynamic profiles of this strategy have been poorly explored. METHODS : This was a prospective, randomized, open-label study conducted in patients on maintenance dosing (MD) of aspirin (81 mg/d) and clopidogrel (75 mg/d). After a 7-day run-in with ticagrelor (180 mg loading dose [LD] followed by 90 mg twice daily MD), patients (n=80) were randomized into 1 of 4 groups: group A, clopidogrel 600 mg LD 24 hours after the last MD of ticagrelor (C-600 mg-24h); group B, clopidogrel 600 mg LD 12 hours after the last MD of ticagrelor (C-600 mg-12h); group C, clopidogrel 75 mg/d MD 24 hours after the last MD of ticagrelor (C-75 mg-24h); and group D, ticagrelor 90 mg twice daily MD (T-90 mg twice daily)...
March 11, 2018: Circulation
C Helten, D Naguib, L Dannenberg, M Pöhl, A Ayhan, T Hohlfeld, B Levkau, M Kelm, T Zeus, A Polzin
BACKGROUND: High on-treatment platelet reactivity (HTPR) to antiplatelet medication leads to ischemic events, while low on-treatment platelet reactivity (LTPR) increases bleeding risk. However, various trials failed to demonstrate superiority of tailored antiplatelet regimes (ARCTIC, ANTARCTIC, Trigger-PCI, GRAVITAS). TROPICAL-ACS was the first study that proved benefit of tailoring antiplatelet medication according to platelet function analyzing. A potential reason may be that different platelet function assays were used in these trials...
March 7, 2018: Journal of Thrombosis and Haemostasis: JTH
Aleš Tomek, Václav Matʼoška, Alena Frýdmanová, Hana Magerová, Martin Šrámek, Jaroslava Paulasova-Schwabová, Tereza Růžičková, Petr Janský, Ivana Šarbochová, Ivana Hadačová, Vojtěch Kaplan, Zuzana Lacinová, Luděk Táborský, Victor Serebruany
BACKGROUND: Variable response after clopidogrel is well documented and may affect major adverse clinical events after stroke. Impact of CYP2C19 genetic polymorphisms is an established marker linked to variable response after clopidogrel. However, the association of certain genetic polymorphisms with prediction of major adverse clinical events following stroke still remains controversial, especially in Caucasians. STUDY QUESTION: The primary aim was to evaluate the impact of CYP2C19 allele *2 in heterozygote form on major adverse clinical events in Caucasian poststroke survivors treated with clopidogrel...
March 2018: American Journal of Therapeutics
J G Brunet, J K Iyer, M S Badin, L Graf, K A Moffat, M Timleck, E Spitzer, C P M Hayward
INTRODUCTION: Dense granule (DG) deficiency (DGD) is a feature of some platelet function disorders (PFD) with a prevalence similar to von Willebrand disease. Most laboratories assess for DGD using whole mount platelet preparations and electron microscopy (EM). We evaluated our experiences with this test and associations between DGD and bleeding. METHODS: Dense granule EM records for 2006-2017 were examined for patients and simultaneously tested controls, and for an overlapping PFD study cohort to evaluate findings and their relationship to bleeding...
March 6, 2018: International Journal of Laboratory Hematology
Marja K Puurunen, Shih-Jen Hwang, Martin G Larson, Ramachandran S Vasan, Christopher J O'Donnell, Geoffrey Tofler, Andrew D Johnson
BACKGROUND: Platelet function is associated with adverse events in patients with cardiovascular disease (CVD). METHODS AND RESULTS: We examined associations of baseline platelet function with incident CVD events in the community-based FHS (Framingham Heart Study). Participants free of prevalent CVD and without recent aspirin treatment with available data in the Framingham Offspring cohort (1991-1995) and Omni cohort (1994-1998) were included. Platelet function was measured with light transmission aggregometry using collagen (1...
March 3, 2018: Journal of the American Heart Association
Lee P Ferguson, Phuoc Duong, Kim F Pearce, Paul Murphy, Tina T Biss
The optimal method for monitoring antiplatelet therapy in children supported with ventricular assist devices (VADs) is unknown. We conducted a retrospective study to compare Thromboelastography Platelet Mapping (TEG/PM) with multiple electrode platelet aggregometry (MEA) on a Multiplate analyzer (Roche Diagnostics, Mannheim, Germany). We analyzed data from 66 paired blood samples from 9 patients <16 years of age on VAD where platelet function was simultaneously measured with TEG/PM and MEA. Antiplatelet dose-response relationships and intraindividual variability during steady state therapy were determined...
February 27, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Tomoyuki Sasaki, Toshiaki Shirai, Nagaharu Tsukiji, Shimon Otake, Shogo Tamura, Jiro Ichikawa, Makoto Osada, Kaneo Satoh, Yukio Ozaki, Katsue Suzuki-Inoue
BACKGROUND: Rhodocytin, a disulfide-linked heterodimeric C-type lectin consisting of α- and β-subunits from Calloselasma rhodostoma, induces platelet aggregation through C-type lectin-like receptor 2 (CLEC-2). CLEC-2 is a physiological binding partner of podoplanin (PDPN) expressed on some tumor cell types and is involved in tumor cell-induced platelet aggregation and tumor metastasis. Thus, modified rhodocytin may be a possible source for anti-CLEC-2 medicine in both anti-platelet and anti-metastasis therapy...
February 28, 2018: Journal of Thrombosis and Haemostasis: JTH
Lei Zhang, Yi Li, Bai-Song Yang, Lu Li, Xiao-Zeng Wang, Mei-Ling Ge, Quan-Min Jing, Ying-Yan Ma, Geng Wang, Hai-Wei Liu, Xin Zhao, Bin Wang, Kai Xu, Ya-Ling Han
Background: High platelet reactivity (HPR) during clopidogrel treatment predicts postpercutaneous coronary intervention (PCI) ischemic events strongly and independently. Tongxinluo capsules (TCs) are a traditional Chinese medicine formulation used as antiplatelet treatment. However, its efficacy against HPR is not known. The aim of the present study was to evaluate the effects of TCs in acute coronary syndrome (ACS) patients with HPR. Methods: This multicenter, randomized, double-blind, placebo-controlled study prospectively analyzed 136 ACS patients with HPR who underwent PCI...
March 5, 2018: Chinese Medical Journal
Monica Verdoia, Patrizia Pergolini, Lucia Barbieri, Roberta Rolla, Matteo Nardin, Federica Negro, Harry Suryapranata, Giuseppe De Luca
BACKGROUND: Recent trials have failed to demonstrate any clinical benefit from pre-treatment with dual antiplatelet therapy (DAPT) in patients undergoing percutaneous coronary interventions, (PCI), even in the setting of acute coronary syndrome. However, suboptimal platelet inhibition during (PCI) has been shown to enhance the risk of acute ischemic complications, such as stent thrombosis and periprocedural myocardial infarction (PMI), thus raising the attention on the potential advantages of adjunctive glycoprotein IIbIIIa inhibitors to obviate to the delayed onset of action of oral antiplatelet drugs...
February 15, 2018: Thrombosis Research
Chih-Hsuan Hsia, Thanasekaran Jayakumar, Joen-Rong Sheu, Shin-Yi Tsao, Marappan Velusamy, Chih-Wei Hsia, Duen-Suey Chou, Chao-Chien Chang, Chi-Li Chung, Themmila Khamrang, Kao-Chang Lin
The regulation of platelet function by pharmacological agents that modulate platelet signaling has proven to be a positive approach to the prevention of thrombosis. Ruthenium complexes are fascinating for the development of new drugs, as they possess numerous chemical and biological properties. The present study aims to evaluate the structure-activity relationship (SAR) of newly synthesized ruthenium (II) complexes, TQ-1, TQ-2 and TQ-3 in agonists-induced washed human platelets. Silica gel column chromatography, aggregometry, immunoblotting, NMR, and X-ray analyses were performed in this study...
February 22, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
Florian Prüller, Oliver Leopold Milke, Lukasz Bis, Friedrich Fruhwald, Daniel Scherr, Philipp Eller, Sascha Pätzold, Siegfried Altmanninger-Sock, Peter Rainer, Jolanta Siller-Matula, Dirk von Lewinski
The majority of resuscitated patients present with underlying cardiac disease, and out of these myocardial infarction is most common. Immediate interventional treatment is recommended and routinely requires dual antiplatelet therapy including aspirin and a P2Y12-inhibitor. Therapeutic hypothermia or target temperature management is also recommended in these patients. Cardiogenic shock as well as reduced body temperature impacts platelet reactivity and its medical inhibition. The study aims to quantify aspirin- and P2Y12-mediated platelet inhibition in patients presenting with myocardial infarction and cardiopulmonary resuscitation...
February 21, 2018: Annals of Intensive Care
Susan C Fox, Jane A May, Natalia Dovlatova, Jackie R Glenn, Andrew Johnson, Ann E White, Ashwin Radhakrishnan, Stan Heptinstall
Measurement of P-selectin on activated platelets as a means of measuring platelet function utilizing the technology described here has the advantage of not requiring immediate access to specialist equipment and expertise. Blood samples are activated, fixed, stored, and transported to a central laboratory for flow cytometric analysis. Here we have compared P-selectin with other more traditional approaches to measuring platelet function in blood and/or platelet-rich plasma (PRP) from patients with acute coronary syndromes on treatment for at least 1 month with either aspirin and clopidogrel or aspirin with prasugrel...
February 20, 2018: Platelets
Yuriy I Grinshtein, Aleksandra A Kosinova, Igor Y Grinshtein, Tatyana N Subbotina, Andrey A Savchenko
AIM: To determine if there is an association between the single nucleotide polymorphisms (SNPs): rs2046934, rs1126643, rs5918, rs6065, rs4244285; rs4986893 and the occurrence of cardiovascular events (CVE) in patients following coronary artery bypass grafting (CABG) surgery. MATERIALS AND METHODS: The study included 130 CABG patients with stable angina grades II-IV. After CABG 69 of the patients were treated with acetylsalicylic acid (ASA) alone, and 61 received dual antiplatelet therapy (ASA+clopidogrel)...
February 20, 2018: Genetic Testing and Molecular Biomarkers
Roy Beigel, Israel Mazin, Edward Koifman, Michael Shechter, Hanna Pres, Nir Shlomo, Nurit Rosenberg, Elad Asher, Shlomi Matetzky
BACKGROUND: Recent studies have shown that the thromboxaneA 2 -dependent pathway is dependent upon the adenosine diphosphate (ADP)-P2Y 12 pathway and that strong P2Y 12 receptor blockade alone causes inhibition of platelet aggregation that is minimally enhanced by aspirin. Data from the PLATO trial suggested that among ticagrelor-treated patients, high compared with low dose (<100mg\day) aspirin is associated with increased risk for ischemic events. OBJECTIVES: In the current prospective, randomized, placebo-controlled, double-blind, cross-over study, we sought to evaluate the impact of aspirin withdrawal on platelet reactivity in acute coronary syndrome (ACS) patients treated with a potent P2Y 12 blocker...
February 14, 2018: Journal of Thrombosis and Haemostasis: JTH
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