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ASA 500 mg i.v. Monitoring platelet function using the Multiplate ® analyzer.

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Presentation on theme: "ASA 500 mg i.v. Monitoring platelet function using the Multiplate ® analyzer."— Presentation transcript:

1 ASA 500 mg i.v. Monitoring platelet function using the Multiplate ® analyzer

2 > Status Quo in most clinics Aspirin Clopidogrel Abciximab Tirofiban Aspirin Clopidogrel antiplatelet medications are given to a large number of patients in most clinics no monitoring of antiplatelet therapy is performed Integrillin Tirofiban Clopidogrel Aspirin Integrillin Abciximab Aspirin Clopidogrel

3 simple whole-blood- based 1-3 different tests single channel high test price cartridge-based platelet function tests complicated low standardisation used in research and reference labs born aggregation flow cytometry Platelet Function Analysis Market

4 simple whole-blood- based 1-3 different tests single channel high test price cartridge-based platelet function tests complicated low standardisation used in research and reference labs born aggregation flow cytometry Platelet Function Analysis Market easy-to-use multi-channel several tests available open system Multiplate ®

5 firm adhesion and aggregation of platelets on the sensor surface enhances the electrical resistance between the 2 sensor wires > principle of Multiplate ® analysis

6 multiple platelet function analyzer Compact (10 x 15 x 4) 5 independent channels Integrated computer Windows XP based software Automatic pipetting optionally available > Multiplate ® instrument

7 PTFE-coated stirrer 2 sensors with 2 electrodes each plug portion pipetting inlet cup > Multiplate ® test cell

8 test 1+2 > Multiplate ® - Parameters

9 : TRAP platelet activation GpIIb /IIIa receptor exposure degranulation ADP Arachidonic Acid Collagen ArA 1 COX TXA 2 COLtest ASPItest TRAPtest ADPtest PGE1 ADPtest HS (ADP + PGE1) activation inhibition GpIIb/IIIa antagonists: Reopro ® (abciximab) Aggrastat ® (Tirofiban) Integrillin ® (Eptifibatid) Aspirin ® NSAR Clopidogrel Prasugrel Cangrelor 1 release of arachidonic acid > Multiplate ® test procedures

10 >ADPtest HS: ADP + Prostaglandin E1 Activation Receptor exposure ADP PGE1 Ca 2+ + - Clopidogrel Binding of ADP to the P2Y12 receptor lowers cAMP and enhances release of Ca 2+ from intracellular stores (+). Plavix interferes with this interaction. PGE1 binds to the platelet and raises cAMP which reduces Ca 2+ mobilisation (-). Ca 2+ cAMP

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