platelet function tests


Summary: Laboratory examination used to monitor and evaluate platelet function in a patient's blood.

Top Publications

  1. Bouman H, Parlak E, van Werkum J, Breet N, ten Cate H, Hackeng C, et al. Which platelet function test is suitable to monitor clopidogrel responsiveness? A pharmacokinetic analysis on the active metabolite of clopidogrel. J Thromb Haemost. 2010;8:482-8 pubmed publisher
    Multiple platelet function tests claim to be P2Y12-pathway specific and capable of capturing the biological activity of clopidogrel...
  2. Lordkipanidzé M. Advances in monitoring of aspirin therapy. Platelets. 2012;23:526-36 pubmed
  3. Mallouk N, Labruyère C, Reny J, Chapelle C, Piot M, Fontana P, et al. Prevalence of poor biological response to clopidogrel: a systematic review. Thromb Haemost. 2012;107:494-506 pubmed publisher
    ..This meta-analysis shows that the prevalence of poor biological response depends on the assay employed, the cut-off value and on various unidentified additional factors. ..
  4. Siller Matula J, Trenk D, Schror K, Gawaz M, Kristensen S, Storey R, et al. Response variability to P2Y12 receptor inhibitors: expectations and reality. JACC Cardiovasc Interv. 2013;6:1111-28 pubmed publisher
    ..Moreover, this paper discusses randomized trials, which so far have failed to show that tailored antiplatelet therapy improves clinical outcome, and treatment options for patients with high on-treatment platelet reactivity. ..
  5. Grove E, Storey R, Würtz M. Platelet function testing in atherothrombotic disease. Curr Pharm Des. 2012;18:5379-91 pubmed
    ..high on-treatment platelet reactivity and facilitates individually tailored antiplatelet therapy, yet platelet function tests have still not been adopted into routine clinical practice...
  6. Würtz M, Grove E. Interindividual variability in the efficacy of oral antiplatelet drugs: definitions, mechanisms and clinical importance. Curr Pharm Des. 2012;18:5344-61 pubmed demonstrate substantial clinical benefit of individually tailored antiplatelet therapy according to platelet function tests. This article provides an integrated review of interindividual variability in the efficacy of aspirin and ..
  7. Ait Mokhtar O, Bonello L, Benamara S, Paganelli F. High on treatment platelet reactivity. Heart Lung Circ. 2012;21:12-21 pubmed publisher
    ..Recent studies had demonstrated a relationship between HTPR and ischaemic events in the setting of PCI. Actually the assessment of platelet reactivity in routine practice and its interpretation to make a decision is a debatable issue. ..
  8. Tantry U, Bonello L, Aradi D, Price M, Jeong Y, Angiolillo D, et al. Consensus and update on the definition of on-treatment platelet reactivity to adenosine diphosphate associated with ischemia and bleeding. J Am Coll Cardiol. 2013;62:2261-73 pubmed publisher
    ..diphosphate (ADP) associated with post-percutaneous coronary intervention ischemic events for various platelet function tests (PFTs)...
  9. Tobin W, Kinsella J, Coughlan T, Collins D, O NEILL D, Murphy R, et al. High on-treatment platelet reactivity on commonly prescribed antiplatelet agents following transient ischaemic attack or ischaemic stroke: results from the Trinity Antiplatelet Responsiveness (TRAP) study. Eur J Neurol. 2013;20:344-52 pubmed publisher
    ..The prevalence of ex vivo 'high on-treatment platelet reactivity' (HTPR) to antiplatelet regimens in patients with ischaemic cerebrovascular disease (CVD) is uncertain...

More Information


  1. Würtz M, Hvas A, Kristensen S, Grove E. Platelet aggregation is dependent on platelet count in patients with coronary artery disease. Thromb Res. 2012;129:56-61 pubmed publisher
    ..Whole blood aggregometry is dependent on all major cell lines in whole blood. Importantly, platelet aggregation is significantly associated with platelet count even within the normal range. ..
  2. Cattaneo M. Response variability to clopidogrel: is tailored treatment, based on laboratory testing, the right solution?. J Thromb Haemost. 2012;10:327-36 pubmed publisher
  3. Sharma R, Voelker D, Sharma R, Reddy H, Dod H, Marsh J. Evolving role of platelet function testing in coronary artery interventions. Vasc Health Risk Manag. 2012;8:65-75 pubmed publisher
    ..While we wait for definitive trials, a predictive prognostic algorithm is necessary to individualize antiplatelet therapy with P2Y12 inhibitors based on platelet function assays and genetic testing. ..
  4. Toth O, Calatzis A, Penz S, Losonczy H, Siess W. Multiple electrode aggregometry: a new device to measure platelet aggregation in whole blood. Thromb Haemost. 2006;96:781-8 pubmed
    ..The use of hirudin as an anticoagulant is preferable to the use of citrate. MEA is a promising technique for experimental and clinical applications. ..
  5. Gurbel P, Becker R, Mann K, Steinhubl S, Michelson A. Platelet function monitoring in patients with coronary artery disease. J Am Coll Cardiol. 2007;50:1822-34 pubmed
    ..However, the relations of in vivo platelet function and adverse clinical events to results of ex vivo platelet function tests remain largely unknown...
  6. Solomon C, Hartmann J, Osthaus A, Schöchl H, Raymondos K, Koppert W, et al. Platelet concentrates transfusion in cardiac surgery in relation to preoperative point-of-care assessment of platelet adhesion and aggregation. Platelets. 2010;21:221-8 pubmed publisher
    ..47 and -0.62, p < 0.05). Multiple electrode aggregometry appeared more useful and easier to apply than CPA for preoperatively identifying patients with platelet concentrates transfusion in cardiac surgery. ..
  7. Dawson J, Quinn T, Rafferty M, Higgins P, Ray G, Lees K, et al. Aspirin resistance and compliance with therapy. Cardiovasc Ther. 2011;29:301-7 pubmed publisher
    ..We recruited 90 cases and 90 controls. Complete platelet function tests were available in 177...
  8. Smock K, Saunders P, Rodgers G, Johari V. Laboratory evaluation of clopidogrel responsiveness by platelet function and genetic methods. Am J Hematol. 2011;86:1032-4 pubmed publisher
    ..This article summarizes the currently available laboratory testing, including platelet function tests and genotyping for CYP2C19 variants.
  9. van Werkum J, Harmsze A, Elsenberg E, Bouman H, ten Berg J, Hackeng C. The use of the VerifyNow system to monitor antiplatelet therapy: a review of the current evidence. Platelets. 2008;19:479-88 pubmed publisher
  10. Angiolillo D, Fernandez Ortiz A, Bernardo E, Alfonso F, Macaya C, Bass T, et al. Variability in individual responsiveness to clopidogrel: clinical implications, management, and future perspectives. J Am Coll Cardiol. 2007;49:1505-16 pubmed
    ..This paper reviews the impact of individual response variability to clopidogrel on clinical outcomes and current and future directions for its management. ..
  11. Kalbantner K, Baumgarten A, Mischke R. Measurement of platelet function in dogs using a novel impedance aggregometer. Vet J. 2010;185:144-51 pubmed publisher
    ..05). The findings indicate that the analyser is suitable for the investigation of platelet aggregation in dogs and analysis should be performed on hirudin-anticoagulated blood using optimised agonist concentrations. ..
  12. Anfossi G, Russo I, Trovati M. Platelet dysfunction in central obesity. Nutr Metab Cardiovasc Dis. 2009;19:440-9 pubmed publisher
    ..Thus, a specifically tailored antiaggregating therapy is likely necessary in obese, insulin resistant subjects, especially in the presence of type 2 diabetes mellitus. ..
  13. Grove E, Hvas A, Mortensen S, Larsen S, Kristensen S. Effect of platelet turnover on whole blood platelet aggregation in patients with coronary artery disease. J Thromb Haemost. 2011;9:185-91 pubmed publisher
    ..Once-daily dosing of aspirin might not suffice to adequately inhibit platelet aggregation in patients with an increased platelet turnover. ..
  14. van Werkum J, van der Stelt C, Seesing T, Hackeng C, ten Berg J. A head-to-head comparison between the VerifyNow P2Y12 assay and light transmittance aggregometry for monitoring the individual platelet response to clopidogrel in patients undergoing elective percutaneous coronary intervention. J Thromb Haemost. 2006;4:2516-8 pubmed
  15. Bonello L, Tantry U, Marcucci R, Blindt R, Angiolillo D, Becker R, et al. Consensus and future directions on the definition of high on-treatment platelet reactivity to adenosine diphosphate. J Am Coll Cardiol. 2010;56:919-33 pubmed publisher
    ..This review provides a consensus opinion on the definition of high on-treatment platelet reactivity to ADP based on various methods reported in the literature and proposes how this measurement may be used in the future care of patients. ..
  16. Small D, Payne C, Kothare P, Yuen E, Natanegara F, Teng Loh M, et al. Pharmacodynamics and pharmacokinetics of single doses of prasugrel 30 mg and clopidogrel 300 mg in healthy Chinese and white volunteers: an open-label trial. Clin Ther. 2010;32:365-79 pubmed publisher
    ..Platelet inhibition was significantly higher in Chinese subjects at all time points after a 30-mg dose of prasugrel than after a 300-mg dose of clopidogrel. Both treatments were generally well tolerated. ..
  17. Michelson A, Linden M, Furman M, Li Y, Barnard M, Fox M, et al. Evidence that pre-existent variability in platelet response to ADP accounts for 'clopidogrel resistance'. J Thromb Haemost. 2007;5:75-81 pubmed
    ..These studies provide evidence that 'clopidogrel resistance' is accounted for by a pre-existent variability in platelet response to ADP and this variability is not increased by clopidogrel administration. ..
  18. Prohaska W, Zittermann A, Inoue K, Tenderich G, Lüth J, Köster Eiserfunke W, et al. Preoperative haemostasis testing does not predict requirement of blood products in cardiac surgery. Eur J Med Res. 2008;13:525-30 pubmed
    ..Our data demonstrate that preoperatively performed haemostasis testing is not predictive in estimating the need for blood products in cardiac surgery patients. ..
  19. Kalb M, Potura L, Scharbert G, Kozek Langenecker S. The effect of ex vivo anticoagulants on whole blood platelet aggregation. Platelets. 2009;20:7-11 pubmed publisher
    ..For point-of-care monitoring with immediate analysis after blood withdrawal all tested direct thrombin inhibitors as well as unfractionated heparin can be used as anticoagulants whereas citrate is not recommended. ..
  20. Bal dit Sollier C, Berge N, Boval B, Hovsepian L, Drouet L. Functional variability of platelet response to clopidogrel correlates with P2Y(12) receptor occupancy. Thromb Haemost. 2009;101:116-22 pubmed
    ..An additional 300 mg dose of clopidogrel improves both IPA and P2Y(12) receptor occupancy mostly in the subset of 'low' responders. ..
  21. Kunicki T, Nugent D. The genetics of normal platelet reactivity. Blood. 2010;116:2627-34 pubmed publisher
  22. Scharbert G, Gebhardt K, Sow Z, Duris M, Deusch E, Kozek Langenecker S. Point-of-care platelet function tests: detection of platelet inhibition induced by nonopioid analgesic drugs. Blood Coagul Fibrinolysis. 2007;18:775-80 pubmed
    ..We evaluated the sensitivity of various point-of-care platelet function tests for the detection of platelet inhibition induced by nonopioid analgesic drugs...
  23. Rahe Meyer N, Winterhalter M, Boden A, Froemke C, Piepenbrock S, Calatzis A, et al. Platelet concentrates transfusion in cardiac surgery and platelet function assessment by multiple electrode aggregometry. Acta Anaesthesiol Scand. 2009;53:168-75 pubmed publisher
    ..76, P=0.002). Near-patient platelet aggregation may allow the identification of patients with enhanced risk of PC transfusion, both pre-operatively and upon arrival on the ICU. ..
  24. Kasotakis G, Pipinos I, Lynch T. Current evidence and clinical implications of aspirin resistance. J Vasc Surg. 2009;50:1500-10 pubmed publisher
    ..Suggestions are advanced for the direction of future trials evaluating aspirin resistance in patients with vascular disease. ..
  25. Flood V, Gill J, Morateck P, Christopherson P, Friedman K, Haberichter S, et al. Common VWF exon 28 polymorphisms in African Americans affecting the VWF activity assay by ristocetin cofactor. Blood. 2010;116:280-6 pubmed publisher
    ..Because the VWF:RCo assay depends on ristocetin binding to VWF, mutations (and polymorphisms) in VWF may affect the measurement of "VWF activity" by this assay and may not reflect a functional defect or true hemorrhagic risk. ..
  26. Weber C, Jambor C, Strasser C, Moritz A, Papadopoulos N, Zacharowski K, et al. Normovolemic modified ultrafiltration is associated with better preserved platelet function and less postoperative blood loss in patients undergoing complex cardiac surgery: a randomized and controlled study. J Thorac Cardiovasc Surg. 2011;141:1298-304 pubmed publisher
    ..N-MUF improved general platelet aggregation and reduced postoperative blood loss in a significant manner. However, performing N-MUF did not result in less postoperative transfusion requirements. ..
  27. Buonamici P, Marcucci R, Migliorini A, Gensini G, Santini A, Paniccia R, et al. Impact of platelet reactivity after clopidogrel administration on drug-eluting stent thrombosis. J Am Coll Cardiol. 2007;49:2312-7 pubmed
    ..41, 95% CI 1.04 to 5.63; p = 0.041). Nonresponsiveness to clopidogrel is a strong independent predictor of stent thrombosis in patients receiving sirolimus- or paclitaxel-eluting stents. ..
  28. von Beckerath N, Kastrati A, Wieczorek A, Pogatsa Murray G, Sibbing D, Graf I, et al. A double-blind, randomized study on platelet aggregation in patients treated with a daily dose of 150 or 75 mg of clopidogrel for 30 days. Eur Heart J. 2007;28:1814-9 pubmed
    ..3 P2Y12 Reaction Units; P = 0.004). Administration of a 150 mg oral maintenance dose of clopidogrel results in more intense inhibition of platelet aggregation than administration of the currently recommended 75 mg maintenance dose. ..
  29. Favaloro E. Clinical utility of the PFA-100. Semin Thromb Hemost. 2008;34:709-33 pubmed publisher
    ..The potential future applications for this simple instrument are also briefly assessed. ..
  30. Sharma R, Reddy H, Singh V, Sharma R, Voelker D, Bhatt G. Aspirin and clopidogrel hyporesponsiveness and nonresponsiveness in patients with coronary artery stenting. Vasc Health Risk Manag. 2009;5:965-72 pubmed
    ..This paper is a review for clinicians taking care of such patients with hyporesponsiveness or nonresponsiveness to dual antiplatelet regimen. ..
  31. Rahe Meyer N, Solomon C, Tokuno M, Winterhalter M, Shrestha M, Hahn A, et al. Comparative assessment of coagulation changes induced by two different types of heart-lung machine. Artif Organs. 2010;34:3-12 pubmed publisher
    ..01, ProcMixed test). Our findings suggest that MEA and thromboelastometry reflect impairment of coagulation in cardiac surgery performed on different types of HLM and that platelet function is less affected by MECC than by standard HLM. ..
  32. Truss N, Armstrong P, Liverani E, Vojnovic I, Warner T. Heparin but not citrate anticoagulation of blood preserves platelet function for prolonged periods. J Thromb Haemost. 2009;7:1897-905 pubmed publisher
    ..Consequently, anti-coagulation with heparin, but not citrate, preserves platelet responses for up to 24 h as determined by a range of techniques. ..
  33. Ang L, Palakodeti V, Khalid A, Tsimikas S, Idrees Z, Tran P, et al. Elevated plasma fibrinogen and diabetes mellitus are associated with lower inhibition of platelet reactivity with clopidogrel. J Am Coll Cardiol. 2008;52:1052-9 pubmed publisher
    ..8 +/- 9.0% vs. 49.0 +/- 7.0%, p < 0.001). Elevated plasma fibrinogen (> or =375 mg/dl) in the presence of diabetes mellitus and increased BMI (> or =25 kg/m(2)) are associated with lower PI with clopidogrel in patients with CVD. ..
  34. Bal dit Sollier C, Berge N, Boval B, Dubar M, Drouet L. Differential sensitivity and kinetics of response of different ex vivo tests monitoring functional variability of platelet response to clopidogrel. Thromb Haemost. 2010;104:571-81 pubmed publisher
    ..Our results highlight a limitation of the VASP index, which appears unable to distinguish low, average and high responders early after clopidogrel initiation when P2Y12 occupancy is still low. ..
  35. Sibbing D, Braun S, Morath T, Mehilli J, Vogt W, Schomig A, et al. Platelet reactivity after clopidogrel treatment assessed with point-of-care analysis and early drug-eluting stent thrombosis. J Am Coll Cardiol. 2009;53:849-56 pubmed publisher
    ..001). Low response to clopidogrel assessed with MEA is significantly associated with an increased risk of ST. Further studies are warranted to evaluate the ability of MEA to guide antiplatelet therapy in patients undergoing PCI. ..
  36. Otahbachi M, Simoni J, Simoni G, Moeller J, Cevik C, Meyerrose G, et al. Gender differences in platelet aggregation in healthy individuals. J Thromb Thrombolysis. 2010;30:184-91 pubmed publisher
    ..01). Among the ethnic groups, Caucasian women were most prone to platelet aggregation. Gender is a determinant of agonist effects on platelet aggregability in healthy subjects. ..
  37. Siller Matula J, Christ G, Lang I, Delle Karth G, Huber K, Jilma B. Multiple electrode aggregometry predicts stent thrombosis better than the vasodilator-stimulated phosphoprotein phosphorylation assay. J Thromb Haemost. 2010;8:351-9 pubmed publisher
    ..Platelet hyperreactivity in MEA might be a better risk predictor for stent thrombosis than the assessment of the specific clopidogrel effect with the VASP phosphorylation assay. ..
  38. Patrono C, Rocca B. Drug insight: aspirin resistance--fact or fashion?. Nat Clin Pract Cardiovasc Med. 2007;4:42-50 pubmed
    ..Gaining such knowledge could result in improved care of patients and might avoid the requesting of unnecessary platelet function tests of unproven clinical significance.
  39. Bouman H, van Werkum J, Breet N, ten Cate H, Hackeng C, ten Berg J. A case-control study on platelet reactivity in patients with coronary stent thrombosis. J Thromb Haemost. 2011;9:909-16 pubmed publisher
    ..Furthermore, both early and late ST are strongly and independently associated with heightened on-aspirin platelet reactivity, and dual antiplatelet therapy resistance is more frequent. ..
  40. Breet N, van Werkum J, Bouman H, Kelder J, Ruven H, Bal E, et al. Comparison of platelet function tests in predicting clinical outcome in patients undergoing coronary stent implantation. JAMA. 2010;303:754-62 pubmed publisher
    ..Objective To evaluate the capability of multiple platelet function tests to predict clinical outcome...
  41. Gibbs N. Point-of-care assessment of antiplatelet agents in the perioperative period: a review. Anaesth Intensive Care. 2009;37:354-69 pubmed
    ..The review was based on a Medline search for articles with key words related to "platelet function tests", "point-of-care", and "anaesthesia", published in English between January 1996 ..
  42. Gibson K, Winterburn T, Barrett F, Sharma S, MacRury S, Megson I. Therapeutic potential of N-acetylcysteine as an antiplatelet agent in patients with type-2 diabetes. Cardiovasc Diabetol. 2011;10:43 pubmed publisher
    ..This may increase bioavailability of protective NO in a narrow therapeutic range. Therefore, NAC might represent an alternative or additional therapy to aspirin that could reduce thrombotic risk in type-2 diabetes. ..
  43. Waki K, Hayashi A, Ikeda S, Ikeda S, Nagatsuka K, Honma Y, et al. Measuring platelet aggregation in dialysis patients with a whole blood aggregometer by the screen filtration pressure method. Ther Apher Dial. 2011;15:203-6 pubmed publisher
    ..4 [1.8-7.0] vs. 2.3 [1.3-3.3] µM, P=0.003). We observed similar trends among diabetic HD patients. Whole-blood analysis by the SPF method seems to be a promising way of monitoring platelet function for HD patients...
  44. Topcuoglu M, Arsava E, Ay H. Antiplatelet resistance in stroke. Expert Rev Neurother. 2011;11:251-63 pubmed publisher
  45. Bilgin A, Karadogan I, Artac M, Kizilors A, Bligin R, Undar L. Hemodialysis shortens long in vitro closure times as measured by the PFA-100. Med Sci Monit. 2007;13:CR141-5 pubmed
    ..As a sensitive, specific, reproducible, easy to perform, and noninvasive test for platelet-related primary hemostasis, the PFA-100 system may become a useful tool for an overall evaluation of primary hemostasis in patients with ESRD. ..
  46. Price M, Angiolillo D, Teirstein P, Lillie E, Manoukian S, Berger P, et al. Platelet reactivity and cardiovascular outcomes after percutaneous coronary intervention: a time-dependent analysis of the Gauging Responsiveness with a VerifyNow P2Y12 assay: Impact on Thrombosis and Safety (GRAVITAS) trial. Circulation. 2011;124:1132-7 pubmed publisher
    ..The efficacy of an individualized strategy to target a level of OTR below this threshold merits investigation. Clinical Trial Registration- Unique identifier: NCT00645918. ..
  47. Favaloro E. Internal quality control and external quality assurance of platelet function tests. Semin Thromb Hemost. 2009;35:139-49 pubmed publisher
    ..EQA organizations may be best placed to act as facilitators to the process of improving diagnostic testing for platelet function, which supplements the role of expert organizations. ..
  48. Elsenberg E, van Werkum J, van de Wal R, Zomer A, Bouman H, Verheugt F, et al. The influence of clinical characteristics, laboratory and inflammatory markers on 'high on-treatment platelet reactivity' as measured with different platelet function tests. Thromb Haemost. 2009;102:719-27 pubmed publisher
    ..clinical and laboratory parameters that are associated with HCPR and HAPR as measured with different platelet function tests. 530 clopidogrel and aspirin pre-treated patients undergoing elective PCI (percutaneous coronary ..
  49. Velik Salchner C, Maier S, Innerhofer P, Kolbitsch C, Streif W, Mittermayr M, et al. An assessment of cardiopulmonary bypass-induced changes in platelet function using whole blood and classical light transmission aggregometry: the results of a pilot study. Anesth Analg. 2009;108:1747-54 pubmed publisher
  50. Lordkipanidzé M, Pharand C, Schampaert E, Turgeon J, Palisaitis D, Diodati J. A comparison of six major platelet function tests to determine the prevalence of aspirin resistance in patients with stable coronary artery disease. Eur Heart J. 2007;28:1702-8 pubmed
    We sought to compare the results obtained from six major platelet function tests in the assessment of the prevalence of aspirin resistance in patients with stable coronary artery disease...
  51. Aradi D, Magyarlaki T, Tokes Fuzesi M, Rideg O, Vorobcsuk A, Komocsi A. Comparison of conventional aggregometry with VASP for monitoring P2Y12-specific platelet inhibition. Platelets. 2010;21:563-70 pubmed publisher
    ..These results reject a commonly used hypothesis and might contribute to the standardization of the LTA assay. ..
  52. Seyfert U, Haubelt H, Vogt A, Hellstern P. Variables influencing Multiplate(TM) whole blood impedance platelet aggregometry and turbidimetric platelet aggregation in healthy individuals. Platelets. 2007;18:199-206 pubmed
    ..The clinical significance of IPA determined using the Multiplate device remains to be determined in studies on patients with platelet dysfunction and under treatment with antiplatelet agents. ..