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Updated: Aug 23, 2026
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Measurement of platelet aggregation during antiplatelet therapy in ischemic stroke
1Department Neurology, Central Hospital, Budapest, Hungary. epongracz@bm.gov.hu
Insights
Antiplatelet drugs like aspirin, ticlopidine, and clopidogrel help prevent recurrent ischemic strokes. Platelet aggregation tests can guide personalized dosing for effective secondary stroke prevention.
Area of Science:
- Neurology
- Pharmacology
- Clinical Laboratory Science
Background:
- Ischemic stroke recurrence is a significant concern, with antiplatelet therapy being a primary preventive measure.
- Aspirin, ticlopidine, and clopidogrel are commonly prescribed antiplatelet agents for secondary stroke prevention.
- Assessing laboratory effectiveness of platelet inhibition is crucial for optimizing patient outcomes.
Purpose of the Study:
- To standardize platelet aggregation technology across multiple centers for reliable laboratory screening.
- To compare the effectiveness of laboratory tests in patients receiving antiplatelet therapy for ischemic stroke.
- To evaluate the efficacy of aspirin, ticlopidine, and clopidogrel in achieving effective platelet inhibition for stroke prevention.
Main Methods:
- Standardization of platelet aggregation assays using CARAT TX aggregometer with collagen, epinephrine, arachidonic acid, and ADP on samples from 150 healthy individuals.
- Comparison of laboratory test results in platelet-rich plasma from 823 ischemic cardiovascular and stroke patients on aspirin (100-325 mg/d).
- Evaluation of platelet aggregation in 555 aspirin-treated, 96 ticlopidine-treated, and 67 clopidogrel-treated ischemic stroke patients.
Main Results:
- Mean platelet aggregation inhibition levels in aspirin-treated patients were 38% (collagen), 37% (epinephrine), and 61% (ADP).
- Ineffective platelet inhibition was observed in 17% of aspirin users, 4% of ticlopidine users, and 18% of clopidogrel users (ADP).
- Effective platelet inhibition rates in the stroke cohort were 36% for aspirin, 73% for ticlopidine, and 25% for clopidogrel.
Conclusions:
- Platelet aggregation testing provides a valuable tool for assessing the efficacy of antiplatelet therapy.
- Laboratory standardization is essential for consistent and reliable evaluation of platelet inhibition across different centers.
- Personalized antiplatelet dosing guided by laboratory testing may optimize secondary ischemic stroke prevention.
Abstract:
Aspirin, ticlopidine and clopidogrel are used as a pharmacological means to efficiently decrease the number of reoccurrence of ischemic stroke (100-325 mg/d). This antiplatelet treatment could prevent the secondary stroke by approximately 22%. Laboratory effective platelet inhibition for the clinician, and methods for routine screening evaluation for the laboratory were studied. (1) For the standardisation of platelet aggregation technology blood samples of 150 healthy persons were studied in 5 centres. CARAT TX computerised optical aggregometer was used for measuring with collagen (2 microg/ml), epinephrine (10 microM), arachidonic acid 0.5 mM and ADP 5 microM as inductors. (2) Laboratory tests were compared in each centres performed in platelet-rich plasma of ischemic cardiovascular and stroke patients (n=823) taking 100-325 mg aspirin/d. (3) Blood samples of 555 ischemic stroke patients treated with aspirin (100-325 mg/d), 96 patients treated with ticlopidine (500 mg/d), and 67 patients treated with clopidogrel (75 mg/d) were evaluated, respectively.(1) The mean of maximal aggregation (%) - 2SD of untreated controls (n=150) were detected for collagen with 64%, epinephrine 59% and ADP 62%. (2) In 823 aspirin treated patients were found similar inhibition in different centres with same methods for standardisation. The mean inhibition level was in case of collagen 38%, epinephrine 37% and ADP 61%. (3) The distribution of ineffective platelet inhibition was detected in 17% of aspirin group (collagen and epinephrine), 4% of ticlopidine and 18% of clopidogrel group with ADP, respectively. Our findings were in the stroke cohort: effective inhibition levels: 36% in aspirin group, 73% in ticlopidine and 25% treated with clopidogrel. Platelet aggregation tests could help to find the optimal, and "custom taylored" dose of antiaggregating drugs in the secondary prevention of ischemic stroke.
