Near-site monitoring of the antiplatelet drug abciximab using the hemodyne analyzer and modified thrombelastograph

Philip E. Greilich, Barbara M. Alving, David Longnecker, Marcus E. Carr, Charles W. Whitten, Audrey S. Chang, Thomas J. Reid

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objective: This investigation examines the hypothesis that the antiplatelet effect of abciximab and its reversal can be monitored using the Hemodyne (Hemodyne, Inc, Midlothian, VA) analyzer and modified Thrombelastograph (Haemoscope, Skokie, IL). Design: In vitro dose-response and reversal study. Setting: Anesthesia Research (Dallas, TX) and Special Studies Coagulation Laboratories (Washington, DC). Participants: Nine healthy volunteers. Interventions: The addition of increasing concentrations of abciximab, 0 to 10 μg/mL, and purified fibrinogen, 50 to 400 mg/dL. The reversal of abciximab, 4 μg/mL, with the addition of fresh platelet-rich plasma (PRP) sufficient to increase the platelet concentration by approximately 10%. Measurements and Main Results: Platelet aggregation and platelet contractile force using the Hemodyne analyzer were used as platelet- specific measurements. The Thrombelastograph maximum amplitude (MA) for platelets (MA(PLT)) was calculated by subtracting the MA from a platelet- poor plasma (PPP) sample (MA(ppp)) determined in one thromboelastography well from that of whole-blood MA (MA(WB)) run simultaneously in the second thromboelastography well. The addition of abciximab, 0 to 10 μg/mL, resulted in significant concentration-dependent reductions in platelet aggregation (p < 0.001), platelet contractile force (p < 0.001), and MA(PLT) (p < 0.001). Platelet contractile force (p < 0.03) and MA(PLT) (p < 0.05) were significantly more responsive than MAws to the effect of abciximab, 4 μg/mL, and its reversal with the addition of fresh PRP. Purified fibrinogen concentration directly correlated with thromboelastography MA (r(s) = 0.97; p < 0.001), yet had no effect on platelet contractile force. The addition of abciximab had no measurable influence on the MA(ppp). Conclusion: This in vitro study suggests that the Hemodyne analyzer and modified Thrombelastograph might be clinically useful methods to monitor the platelet inhibitory effects of agents such as abciximab.

Original languageEnglish (US)
Pages (from-to)58-64
Number of pages7
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume13
Issue number1
StatePublished - Feb 1999

Fingerprint

Platelet Aggregation Inhibitors
Blood Platelets
Thrombelastography
Platelet-Rich Plasma
Platelet Aggregation
Fibrinogen
abciximab
Healthy Volunteers
Anesthesia

Keywords

  • Abciximab
  • Blood
  • Hemodyne
  • Platelet aggregation
  • Platelet contractile force
  • Platelet function
  • Platelet function monitoring
  • Platelet inhibition
  • Platelets
  • Shear elasticity
  • Thrombelastograph

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Near-site monitoring of the antiplatelet drug abciximab using the hemodyne analyzer and modified thrombelastograph. / Greilich, Philip E.; Alving, Barbara M.; Longnecker, David; Carr, Marcus E.; Whitten, Charles W.; Chang, Audrey S.; Reid, Thomas J.

In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 13, No. 1, 02.1999, p. 58-64.

Research output: Contribution to journalArticle

Greilich, Philip E. ; Alving, Barbara M. ; Longnecker, David ; Carr, Marcus E. ; Whitten, Charles W. ; Chang, Audrey S. ; Reid, Thomas J. / Near-site monitoring of the antiplatelet drug abciximab using the hemodyne analyzer and modified thrombelastograph. In: Journal of Cardiothoracic and Vascular Anesthesia. 1999 ; Vol. 13, No. 1. pp. 58-64.
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AU - Alving, Barbara M.

AU - Longnecker, David

AU - Carr, Marcus E.

AU - Whitten, Charles W.

AU - Chang, Audrey S.

AU - Reid, Thomas J.

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N2 - Objective: This investigation examines the hypothesis that the antiplatelet effect of abciximab and its reversal can be monitored using the Hemodyne (Hemodyne, Inc, Midlothian, VA) analyzer and modified Thrombelastograph (Haemoscope, Skokie, IL). Design: In vitro dose-response and reversal study. Setting: Anesthesia Research (Dallas, TX) and Special Studies Coagulation Laboratories (Washington, DC). Participants: Nine healthy volunteers. Interventions: The addition of increasing concentrations of abciximab, 0 to 10 μg/mL, and purified fibrinogen, 50 to 400 mg/dL. The reversal of abciximab, 4 μg/mL, with the addition of fresh platelet-rich plasma (PRP) sufficient to increase the platelet concentration by approximately 10%. Measurements and Main Results: Platelet aggregation and platelet contractile force using the Hemodyne analyzer were used as platelet- specific measurements. The Thrombelastograph maximum amplitude (MA) for platelets (MA(PLT)) was calculated by subtracting the MA from a platelet- poor plasma (PPP) sample (MA(ppp)) determined in one thromboelastography well from that of whole-blood MA (MA(WB)) run simultaneously in the second thromboelastography well. The addition of abciximab, 0 to 10 μg/mL, resulted in significant concentration-dependent reductions in platelet aggregation (p < 0.001), platelet contractile force (p < 0.001), and MA(PLT) (p < 0.001). Platelet contractile force (p < 0.03) and MA(PLT) (p < 0.05) were significantly more responsive than MAws to the effect of abciximab, 4 μg/mL, and its reversal with the addition of fresh PRP. Purified fibrinogen concentration directly correlated with thromboelastography MA (r(s) = 0.97; p < 0.001), yet had no effect on platelet contractile force. The addition of abciximab had no measurable influence on the MA(ppp). Conclusion: This in vitro study suggests that the Hemodyne analyzer and modified Thrombelastograph might be clinically useful methods to monitor the platelet inhibitory effects of agents such as abciximab.

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