Sonoclot Analyzer and Platelet Aggregometry Detect Platelet Receptor (GPIIb/IIIa) Blockade

Sonoclot Analyzer and Platelet Aggregometry Detect Platelet Receptor (GPIIb/IIIa) Blockade

Yue Dong, M.D.; Gregory A. Nuttall, M.D.; William C. Oliver, M.D.; Mark H. Ereth, M.D. Anesthesiology, Mayo Clinic, Rochester, Minnesota, United States

[Background] Abciximab blocks the major platelet surf ace receptor (GPIIb/IIIa), which is critical to platelet aggregation. Practical means to monitor platelet f unction in patients on abciximab undergoing emergency cardiac surgery is needed.

[Methods] After Institutional Review Board approval and informed consent, blood samples

were draw n from 20 healthy volunteers. Celite activated Sonoclot analysis and ADP activated Platelet Poor Plasma (PRP) aggregometry were completed after addition of abciximab. The Sonoclot analysis and ADP activated PRP aggregometry were used to detect platelet

function. The data was analyzed by student's t test and P<0.05 is statistically significant.

[Result]ACT=Activated Clotting Time, PF=Sonoclot calculated platelet function

[Discussion] Sonoclot analysis Time to Peak and PF values accurately reflect GPIIb/IIIa receptor blockade. Unlike platelet aggregometry which is the time consuming and labor intensive, the Sonoclot analyzer is a user friendly point of care test, which yields good results. Thus, Sonoclot analyzer provides rapid assessment of platelet function that could allow for adjustment of abciximab therapy or to direct platelet transfusion in the setting of cardiac surgery.

Anesthesiology 2001; 95:A192

		Control	Abciximab	Abciximab	P-value
			0.125mg/kg	0.25mg/kg
Sonoclot	ACT ( sec)	167±38	155±21	159±30	NS
	Clot Rate (unit/min)	14.9±3.9	15.7±5.5	14.2±3.9	NS
	Time to Peak(min)	11.0±3.1*	13.0±3.5	18.1±5.2*	*<0.05
	PF	2.5±1.3*	-	1.3±0.9*	*<0.05
Aggregometry	% Aggregation	85.2±6.1*	19.2±11.3*	9.4±4.2*	*<0.05
n		20	10	20

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