Key result
VWF bead-induced platelet activation detects dysfunction in ~90% of mild bleeding cases versus conventional aggregometry.
Why the study?
Easily-bruised patients may have platelet function defects that are not detected by conventional optical aggregometry, necessitating more sensitive platelet activation tests.
Does VWF bead-induced platelet activation improve the detection of platelet dysfunction compared to conventional optical aggregation in patients with mild bleeding?
Cross-Sectional (n=30)
Does VWF bead-induced platelet activation improve the detection of platelet dysfunction compared to conventional optical aggregation in patients with mild bleeding?
VWF bead-induced platelet activation appears to be a more sensitive test for detecting platelet dysfunction in patients with mild bleeding compared to conventional aggregometry.
May improve platelet dysfunction detection in mild bleeding; animal data leave clinical adoption open pending human validation.
The interaction between platelets stirred in suspension and VWF immobilized on polystyrene beads was studied. Platelets aggregated and released ATP in response to stirring with VWF beads. Closer examination of the interaction using transmission electron microscopy revealed that the platelets did not simply aggregate with one another but initially adhered to the beads and spread. Platelets in suspension then bound to the bead-adherent platelets forming layers of platelets associated with each bead. The VWF bead-induced platelet activation was completely inhibited by addition of monoclonal antibody (mAb) to GPIb or GPIIb/IIIa. In addition, the activation response was inhibited in the presence of aspirin, indomethacin or the thromboxane receptor antagonist BM13.177, demonstrating a dependence on an intact cyclo-oxygenase pathway. Platelet function studies were carried out on 30 patients with a history of mild bleeding using conventional optical aggregation and VWF bead-induced platelet activation. 12 patients were abnormal by conventional optical aggregometry, whereas 27 patients showed depressed ATP release in response to VWF beads. The results suggest that easily-bruised patients may have a platelet function defect rather than a vascular-based abnormality and that VWF bead-induced platelet activation is a more sensitive test for detecting platelet dysfunction.
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Stewart et al. (1997) conducted a cross-sectional in History of mild bleeding (n=30). VWF bead-induced platelet activation vs. Conventional optical aggregation was evaluated on Detection of abnormal platelet function. VWF bead-induced platelet activation detected platelet dysfunction in 90% of patients with mild bleeding, compared to 40% using conventional optical aggregometry.
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