Diagnostic usefulness of a lumi-aggregometer adenosine triphosphate release assay for the assessment of platelet...

Area of Science:

• Hematology
• Clinical Pathology

Background:

• Platelet dense granule release assays, particularly adenosine triphosphate (ATP) release, are crucial for diagnosing platelet function disorders.
• The Lumi-Aggregometer is commonly used for these ATP release assays.

Purpose of the Study:

• To assess the utility of platelet ATP release assays in evaluating bleeding symptoms.
• To determine the association between reduced ATP release and bleeding disorders, including inherited platelet function disorders.

Main Methods:

• A prospective cohort study was conducted on individuals tested for ATP release defects.
• Adenosine triphosphate (ATP) release was measured using agonists like epinephrine, collagen, and U46619.
• Bleeding symptoms and disorders were assessed in relation to ATP release and platelet aggregation findings.

Main Results:

• Reduced ATP release was significantly more prevalent in patients with bleeding disorders compared to healthy controls (P < .001).
• Reduced ATP release with one or more agonists showed a high likelihood of bleeding disorders (OR, 17 [6-46]) and inherited platelet function disorders (OR, 128 [30-545]).
• These associations remained significant even when platelet aggregation was normal (OR, 12 [4-34] and 105 [20-565], respectively).
• The combination of epinephrine, collagen, and U46619 demonstrated high specificity and moderate sensitivity for detecting inherited platelet function disorders.

Conclusions:

• Platelet ATP release assays are effective tools for evaluating common bleeding disorders.
• The diagnostic utility of ATP release assays is independent of platelet aggregation findings.
• These assays are particularly useful for identifying inherited platelet function disorders.