Blood platelets play a pivotal role in physiological hemostasis. Disorders of platelet function in general manifest most clearly as either bleedings or thrombotic disorders hence platelet function testing can be utilised in the analysis of inherited and acquired platelet function disorders. The Multiplate® Analyser can detect platelet dysfunction and thus may be used to aid in the diagnosis and clinical management of patients with platelet function disorders.2,3
The Multiplate® Analyser may also be used to monitor the patient’s response to antiplatelet drugs and guide selection of antiplatelet therapies.4 The Multiplate® Analyser was the device used in the first large randomised controlled trial that demonstrated the safety and efficacy of switching of drug regimen based on platelet function testing (PFT), TROPICAL ACS.5 In the TROPICAL-ACS study, patients with acute coronary syndrome undergoing PCI were treated with either 1) one week of prasugrel followed by 1 week of clopidogrel and PFT-guided maintenance therapy with clopidogrel or prasugrel or 2) with prasugrel only. There were no differences in ischaemic and bleeding events in both groups with this approach. The authors conclude: “Guided de-escalation of antiplatelet treatment was non-inferior to standard treatment with prasugrel at 1 year after PCI in terms of net clinical benefit”. Hence early de-escalation of antiplatelet treatment from prasugrel to clopidogrel guided by Multiplate® platelet function testing results could be an alternative approach to standard treatment regimens.5
The Multiplate® Analyser may also be used as a pre-surgical and/or perioperative tool to aid in the prediction of bleeding and for monitoring the efficacy of various types of prohemostatic therapies.6-9 Studies have shown that Multiplate® results, used in conjunction with clinical presentation and additional laboratory markers, may be used to help determine timing of surgery after stopping antiplatelet therapy.10, 11 Multiplate® results may also be used to assess platelet function perioperative and could be integrated into institution transfusion algorithm to reduce platelet transfusion rates and hence risks from potential complications of platelet transfusion.12 Reduced platelet transfusions may also help to reduce costs.