J. David Ogilby*, Nelson M. Wolf, David G.M. Carville, Patricia A. Schleckser, Kirk E. Guyer. Allegheny University of the Health Sciences, Philadelphia, PA and Array Medical Laboratories, Indiana University, South Bend, IN
Platelet receptor blockade has improved the safety of patients undergoing PTCA by reducing the incidence of acute thrombosis and early reclosure. In high-risk patients, Abciximab (ReoProÒ ) a blocker of the Gp IIb/IIIa platelet receptor site has improved clinical PTCA outcome. This study examined the ability of the ICHOR near patient hematology analyzer to assess whole blood platelet aggregation in patients undergoing angioplasty treated with ReoProÒ. Baseline platelet function was analyzed by obtaining baseline platelet count and percent platelet aggregation when exposed to 20 uM ADP. Baseline platelet count was 201 ± 57 x 103 /uL. Baseline ADP aggregation was 84.4 ± 16.3%. The 10 PTCA patients had a pre-aggregation of 88.0 ± 12.4% and after ReoProÒ an aggregation of 26.0 ± 18.6% (p<0.05). Serial measurements of platelet inhibition showed a variable response. This study documented the ability of ReoProÒ to inhibit ADP induced platelet aggregation in patients undergoing PTCA. Other intravenous and oral Gp IIb/IIIa platelet inhibitors are currently beginning clinical use. The ICHOR can assess the efficacy of these new agents while patients are in the catheterization laboratory undergoing interventional procedures. Further clinical studies are needed to document the usefulness of online analysis of platelet receptor blockade.
ABSTRACT PRESENTED AT
INT'L SOCIETY OF THROMBOSIS & HEMOSTASIS
1999
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