Platelet aggregation responses vary over a period of time in healthy controls

Platelet aggregation study is performed to investigate platelet function abnormality. A normal healthy control sample is usually run with the patient sample as a quality control measure. At our institution, we observed variations in platelet aggregation responses in our normal repeat controls. Therefore, we analysed aggregation parameters in these controls. Whole blood aggregation studies were performed with adenosine diphosphate (ADP), arachidonic acid (AA), collagen and ristocetin. Adenosine triphosphate (ATP) secretion was also measured simultaneously by leuciferin-leuciferase reaction. During a 5-year period, a total of 86 studies were performed on seven controls. Aggregations were within the acceptable range in 67% of the time. Collagen was the most affected agonist in our study. On five occasions, four controls had subnormal aggregations with two agonists. All abnormal responses were hypoaggregation except for two who had hyperaggregation with collagen and AA. Only one out of seven controls was always normal. In the presence of a subnormal control result, a new control was run before releasing the patient's platelet aggregation results. These findings suggest that many physiological factors, other than medications, may affect platelet function even in normal individuals. Therefore, a repeat study at a later date to demonstrate a reproducible abnormality would be prudent before labeling a patient's platelets abnormal.