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A Uniform Shear Assay for Human Platelet and Cell Surface Receptors via Cone-plate Viscometry
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Sensitivity of Viscoelastic Tests to Platelet Function.

Marco Ranucci1, Ekaterina Baryshnikova1

  • 1Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, 20097 Milan, Italy.

Journal of Clinical Medicine
|April 15, 2020
PubMed
Summary

Viscoelastic tests assess clot formation and strength. A specific platelet mapping test aims to evaluate platelet function, but its use for antiplatelet agents remains limited, though crucial for managing bleeding disorders.

Keywords:
platelet function testsplateletsviscoelastic methods

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Area of Science:

  • Hemostasis and Thrombosis
  • Coagulation Diagnostics
  • Platelet Function Testing

Background:

  • Viscoelastic tests dynamically assess clot formation and strength.
  • Platelet contribution to clot strength is often inferred but lacks specificity.
  • Standard viscoelastic tests inadequately assess platelet reactivity to certain inhibitors.

Purpose of the Study:

  • To evaluate the utility of viscoelastic tests in assessing platelet function.
  • To explore the limitations of standard viscoelastic tests for antiplatelet agent effects.
  • To highlight the role of platelet contribution in managing coagulopathic bleeding.

Main Methods:

  • Utilizing viscoelastic tests with specific activators/inhibitors to explore coagulation dynamics.
  • Developing and comparing a specific thromboelastography platelet mapping test.
  • Assessing platelet contribution to clot strength in various clinical settings.

Main Results:

  • Standard viscoelastic tests struggle to differentiate platelet count from function and bypass certain activation pathways.
  • A dedicated thromboelastography platelet mapping test shows conflicting results compared to aggregometry.
  • The clinical utility of viscoelastic tests for monitoring antiplatelet agents is currently limited.

Conclusions:

  • Viscoelastic tests offer dynamic coagulation insights but have limitations in assessing platelet function, especially under antiplatelet therapy.
  • Platelet contribution to clot strength is vital for guiding platelet transfusion and desmopressin in bleeding disorders.
  • Further validation of specialized viscoelastic tests is needed for comprehensive platelet function assessment.