Multiplate^® analyzer

The Multiplate analyzer is an easy to use instrument to determine platelet function in small quantities of whole blood, in a highly standardized manner. Whole blood is the physiological environment where platelet function takes place in vivo. The use of whole blood for in vitro testing eliminates the need for time-consuming centrifugation steps.

The term “Multiplate” is derived from the phrase “multiple platelet function analyzer”. The testing method is called multiple electrode aggregometry (MEA). Impedance aggregometry was developed by Cardinal and Flower for the assessment of platelet function in whole blood.²

The 5 channel analyzer, with CE marked tests (ADPtest, ASPItest, TRAPtest, ADP HS)³, has been featured by almost 700 Medline-listed articles and has been reported by several groups to be useful in tailoring antiplatelet therapy, as well as improving the management of bleeding complications in surgical procedures.^4,5

Blood platelets or thrombocytes play a vital role in hemostasis, where they provide the initial primary hemostatic plug at the site of vessel injury to prevent bleeding. A variety of disorders of platelets, both inherited and acquired, can lead to a bleeding diathesis, which can be diagnosed using platelet function analysis¹.

Platelets are also involved in thrombotic disorders and some rare inherited disorders, although the most common clinically are in cardiac disease (Myocardial Infarction) and thrombotic stroke. Development of arterial platelet thrombosis in myocardial infarcts is a leading cause of mortality in western society. To reduce the risk of thrombosis in these patients, antiplatelet medication like Aspirin and the P2Y12 platelet inhibitors clopidogrel, prasugrel and ticagrelor is administered to reduce platelet function. In some patients their response to these antiplatelet agents can be variable, with 30% of patients found as non-responders to clopidogrel⁴.

Platelet function testing can be used to monitor the efficacy of drugs and transition the change to other more effective antiplatelet drugs in non-responders or the de-escalation from one drug to another to reduce the bleeding risk^5,6.

Platelet function testing can be performed in the following clinical scenarios; analysis of platelet function in patients ho have been on antiplatelet medication before cardiac surgery as part of the anesthetic work up to reduce bleeding risk or allowing patients to go for surgery sooner⁷. Monitoring of platelet function antagonists like Aspirin, clopidogrel, prasugrel and ticagrelor in patients at high thrombotic risk or who require de-escalation from one antiplatelet agent to another to reduce bleeding risk ^{4, 5, 7}.

Heparin Induced Thrombocytopenia is another rare, but life-threatening thrombotic disorder, that can be diagnosed via platelet function testing and has been standardized by the ISTH SSC Platelet Immunology committee⁸. 

Platelet function testing supports clinical decision making in:

• Percutaneous Coronary Interventions (PCI)^5,6
• Pre-Cardiac surgery⁹
  
• De-escalation of antiplatelet treatment⁷
• Heparin Induced Thrombocytopenia⁸