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Comparison of multiple electrode aggregometry with lumi-aggregometry for the diagnosis of patients with mild bleeding
R Al Ghaithi1,2, S Drake2, S P Watson2
1Institute of Inflammation and Ageing, University of Birmingham, Edgbaston, Birmingham, UK.
Abstract:
Essentials There is a clinical need for new technologies to measure platelet function in whole blood. Mild bleeding disorders were evaluated using multiple electrode aggregometry (MEA). MEA is insensitive at detecting patients with mild platelet function and secretion defects. More studies are required to investigate MEA in patients with a defined set of platelet disorders.
Summary:
Background Multiple electrode aggregometry (MEA) measures changes in electrical impedance caused by platelet aggregation in whole blood. This approach is faster, more convenient and offers the advantage over light transmission aggregometry (LTA) of assessing platelet function in whole blood and reducing preanalytical errors associated with preparation of platelet-rich plasma (PRP). Several studies indicate the utility of this method in assessing platelet inhibition in individuals taking antiplatelet agents (e.g. aspirin and clopidogrel). Objective Our current study sought to evaluate the ability of MEA in diagnosing patients with mild bleeding disorders by comparison with light transmission lumi-aggregometry (lumi-LTA). Methods Forty healthy subjects and 109 patients with a clinical diagnosis of a mild bleeding disorder were recruited into the UK Genotyping and Phenotyping of Platelets study (GAPP, ISRCTN 77951167). MEA was performed on whole blood using one or two concentrations of ADP, PAR-1 peptide, arachidonic acid and collagen. Lumi-LTA was performed in PRP using several concentrations of ADP, adrenaline, arachidonic acid, collagen, PAR-1 peptide and ristocetin. Results Of 109 patients tested, 54 (49%) patients gave abnormal responses by lumi-LTA to one or more agonists. In contrast, only 16 (15%) patients were shown to have abnormal responses to one or more agonists by MEA. Conclusions In this study we showed that MEA is less sensitive in identifying patients with abnormal platelet function relative to lumi-LTA.
Insights
Multiple Electrode Aggregometry (MEA) is less sensitive than light transmission lumi-aggregometry (lumi-LTA) for diagnosing mild platelet function disorders. Further research is needed to establish MEA
Area of Science:
- Hematology
- Clinical Diagnostics
- Platelet Physiology
Background:
- Multiple Electrode Aggregometry (MEA) assesses platelet function in whole blood via electrical impedance.
- MEA offers advantages over light transmission aggregometry (LTA) by reducing preanalytical errors and processing whole blood.
- Existing studies suggest MEA's utility in monitoring antiplatelet agent effects.
Purpose of the Study:
- To evaluate the diagnostic capability of MEA for mild bleeding disorders.
- To compare the sensitivity of MEA against light transmission lumi-aggregometry (lumi-LTA).
Main Methods:
- Recruited 40 healthy subjects and 109 patients with mild bleeding disorders.
- Performed MEA on whole blood using various agonists (ADP, PAR-1 peptide, arachidonic acid, collagen).
- Conducted lumi-LTA on platelet-rich plasma (PRP) with a broader range of agonists and concentrations.
Main Results:
- Only 15% of patients showed abnormal responses via MEA.
- In contrast, 49% of patients exhibited abnormal responses using lumi-LTA.
- MEA identified significantly fewer patients with abnormal platelet function.
Conclusions:
- MEA demonstrates lower sensitivity in detecting patients with mild platelet function abnormalities compared to lumi-LTA.
- Clinical need exists for improved technologies to measure platelet function in whole blood.
- Further investigation of MEA in specific platelet disorder cohorts is warranted.
