Evaluation of the Platelet Mapping™ Assay on rotational thromboelastometry ROTEM®

Abstract

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. Whole blood was drawn from 22 adult volunteers and patients with and without antiplatelet medication. Platelet aggregability was determined in three whole blood assays: the Platelet Mapping™ Assay using both activators arachidonic acid (AA) and adenosine diphosphate (ADP) on TEG®, its adapted version on ROTEM®, and the multiple electrode impedance aggregometer Multiplate®. Percent aggregation inhibition results were plotted in a linear regression analysis and correlation was estimated. Sensitivity and specificity for detecting antiplatelet medication were determined. Overall correlations were statistically significant 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 86% and 100%, respectively. ADP-activated tests and the Multiplate® analysis identified clopidogrel-inhibition in 67% and 89%, respectively. Specificity was low both in ROTEM® and TEG®. Differences in frequency distribution between the results obtained in ROTEM® and TEG® were not statistically significant. The Platelet Mapping™ Assay can be performed on the ROTEM®. For the perioperative scenario, however, longer test duration and higher costs have to be considered compared to Multiplate® analyses.