Paniccia Rita, Antonucci Emilia, Maggini Niccolò, Romano Eloisa, Gori Anna Maria, Marcucci Rossella, Prisco Domenico, Abbate Rosanna
Departments of Medical and Surgical Critical Care, Thrombosis Center, University of Florence, Italy.
Am J Clin Pathol. 2009 Jun;131(6):834-42. doi: 10.1309/AJCPTE3K1SGAPOIZ.
This study sought to compare Multiplate impedance platelet aggregometry (IPA) with light transmission aggregometry (LTA) and the PFA-100 for determining the prevalence of residual platelet reactivity (RPR) by the Multiplate IPA in 297 patients with acute coronary syndrome receiving dual antiplatelet therapy. Aggregations were induced by adenosine-5 diphosphate (ADP), arachidonic acid, and collagen. PFA-100 closure times were measured by collagen and ADP and epinephrine (CEPI) cartridges. Significant correlations were observed between Multiplate IPA and LTA after all stimulations (P < .0001) and between Multiplate IPA (arachidonate and collagen) and PFA-100 CEPI closure time (P < .0001 for both). Cutoff values of Multiplate IPA (for all stimulations) were calculated for the identification of RPR. Between the Multiplate IPA and LTA good agreement was found with all 3 agonists (P < .0001 for all). Multiplate IPA might represent a reliable, handy, rapid tool to monitor antiplatelet therapy in clinical practice and for clinical investigations.
本研究旨在比较297例接受双联抗血小板治疗的急性冠脉综合征患者中,多电极血小板聚集仪(IPA)与光透射聚集仪(LTA)及血小板功能分析仪-100(PFA-100)在通过多电极血小板聚集仪测定残余血小板反应性(RPR)患病率方面的差异。聚集反应由5-二磷酸腺苷(ADP)、花生四烯酸和胶原诱导。PFA-100封闭时间通过胶原和ADP及肾上腺素(CEPI)检测卡进行测定。在所有刺激后,多电极血小板聚集仪与光透射聚集仪之间观察到显著相关性(P < 0.0001),多电极血小板聚集仪(花生四烯酸盐和胶原)与PFA-100 CEPI封闭时间之间也观察到显著相关性(两者均为P < 0.0001)。计算多电极血小板聚集仪(所有刺激)的临界值以识别RPR。在多电极血小板聚集仪与光透射聚集仪之间,发现与所有3种激动剂均具有良好一致性(所有P < 0.0001)。多电极血小板聚集仪可能是临床实践和临床研究中监测抗血小板治疗的一种可靠、便捷、快速的工具。