RRML - Platelet function monitoring tests in the evaluation of platelet antagonists efficacy

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Dr. Adrian Man

Nr. 13(4)/2008

Platelet function monitoring tests in the evaluation of platelet antagonists efficacy

Elena Bobescu

Abstract:

The development of pharmacologic agents that inhibit platelet function leads to the similar development of laboratory methods for evaluation of therapeutic efficacy, low response or drug resistance and monitoring of complications represented by minor or major bleeding. Specific and non-specific platelet antagonists act by inhibiting one or several platelet functions. Platelet antagonists are in relation with function inhibition agents that inhibit platelet adhesion, activation, aggregation and secretion. Platelet functions monitoring has many applications during surgery, in haematology, in cardiovascular disease and research applications. High spontaneous aggregability, low response or resistance to anti-platelet drugs are risk factors for thromboembolic events. In these conditions many methods were developed for evaluation of platelet and platelet function starting with simple tests like blood smear, platelet count, mean platelet volume, in vivo bleeding time, in vitro bleeding time to more specific and standardised methods such as: Rapid Platelet Function Assay, determination of eicosanoids specific platelets metabolites, flow-cytometric determination of vasodilator-stimulated phosphoprotein phosphorylation, light transmission platelet aggregometry, impedance aggregometry - multiple electrode platelet aggregometry. The last method - impedance aggregometry seems to be the best suited for the clinical monitoring of anti-platelet therapy because it analyzes the platelet function in whole blood, similarly to the in vivo conditions, it is sensitive for all the three classes of commonly used platelet function inhibitors, provides a wide range of aggregation tests, it is standardised and cost effective in comparison with previously used methods.

Keywords: platelet function monitoring,platelet antagonists,drug resistance

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Bobescu E. Platelet function monitoring tests in the evaluation of platelet antagonists efficacy. Rev Romana Med Lab. 2008;13(4):7-16