Other methods-2009-scharbert

Comparison with other methods
Anticoagulant and other drug effects
Rotational thromboelastometry ROTEM® is available as point-of-care coagulation
monitoring in an increasing number of European operating theatres and emergency
rooms. The Platelet Mapping™ Assay has been described as a platelet aggregation
assay for thromboelastography TEG®. The aim of this experimental trial was to
evaluate feasibility of the Platelet Mapping™ Assay on the ROTEM® test system.
Ex vivo study
Whole blood was drawn from 22 adult volunteers and patients with and with-
Platelet aggregability was determined in three whole blood assays: the Platelet Mapping™ Assay using both activators arachidonic acid (AA) and
adenosine diphoshpate (ADP) on TEG® Haemostasis Analyser 5000, its
adapted version on ROTEM® gamma, and the multiple electrode impedance
aggregometer Multiplate®.
Tests were performed in duplicates simultaneously on the three test devices. The Platelet Mapping™ Assay combines three ciscoelastic measurements involving various reagents and preparation steps. As the conventional blood volume is 360 µl in the TEG® and 300 µl in
ROTEM® we adapted to the total test volume accordingly.
Main parameter documented was the maximum amplitude (MA) in the TEG®
and the maximum clot firmness (MCF) in the ROTEM®.
Percent aggregation inhibition results were plotted in a linear regression Sensitivity and specificity for detecting antiplatelet medication were deter- Overall correlation were statistically with an r²=0,83 in AA-activated and an r²=0,82 in ADP-activated Platelet Mapping™Assay. AA-activated tests and the Multiplate® analysis identified aspirin-inhibition in ADP-activiated tests and the Multiplate® analysis identified clopidogrel- inhibition in 67% and 89%, respectively. Specificity was low both in ROTEM® and TEG®. Correlation between Platelet Mapping™ Assay performed on ROTEM® and TEG® in patients on clopidogrel and aspirin were good and highly significant. The Platelet Mapping™ Assay can be performed on the ROTEM®. Coagulation, platelets, platelet aggregation, point-of-care coagulation monitoring, ROTEM®, POC
Conclusions
“The study demonstrates that the Platelet Mapping™Assay designed
for TEG® can be run on the ROTEM®. This information on the feasibility of per-
forming the Platelet Mapping™Assay on the ROTEM® is important for the many
ROTEM® users who are well aware of the diagnostic gap of this viscoelastic
test in terms of platelet function monitoring.”
“The correlation between Platelet Mapping™Assay performed on ROTEM® and
TEG® (r²=0,825) of all available values from all patien ts and volunteers ob-
tained were comparable with the correlation between optic aggregometry and
Multiplate® analyses before and after clopidogrel treatment (r²=0,71).”
“Diagnostic accuracy of this assay for the detection of platelet inhibition
treatment by clopidogrel, aspirin, and diclofenac is inadequate and inferior to
multiple electrode aggregometry using Multiplate®.”

Source: http://www.rotem.de/site/Literatur/z_Digests/Other-Methods-2009-Scharbert.pdf