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Recent studies have identified an important role for platelets in the pathogenesis of coronary artery disease. These studies have demonstrated the high degree of inter- and intra-individual variability in platelet function among patients with stable coronary artery disease and have questioned the ability of standard in vitro assays of platelet function to predict clinical outcome. A novel in vivo assay of platelet function using simultaneous assays of whole blood platelet aggregation (WBA) and thromboxane A2 (TXA2) synthesis (by thrombin-stimulated and platelet-released prostaglandin I2 (PGI2) synthesis) has been developed as an assay of platelet function. In this assay, aspirin and the P2Y12 receptor antagonist, clopidogrel, are administered at specific time intervals after sample collection. Platelet function measured as WBA by aggregometry in whole blood samples (BASP), and platelet-released TXA2 synthesis by enzyme-linked immunosorbent assay (ELISA), were compared with WBA measured by the thrombelastograph (TEG), an assay of intrinsic platelet function. The results of whole blood aggregation assays demonstrated a strong positive association between the WBA and the TEG for WBA induced by epinephrine and arachidonate. For WBA induced by adenosine diphosphate (ADP), the correlation was weaker and less robust. However, when the data were analyzed by platelet function category, WBA induced by epinephrine and arachidonate demonstrated a strong correlation with TEG measured as R-time (lag time), maximal platelet aggregation (MA) and platelet mass (PM). The correlation was not as strong with WBA induced by ADP, with weaker correlations observed for R-time and MA. In contrast, for WBA induced by ADP, a strong correlation was observed for WBA by light transmission aggregometry (LTA) and TEG measured as maximum amplitude. These data suggest that, although LTA may be a more sensitive assay of platelet aggregation, the TEG assay has improved predictivity for whole blood aggregation induced by epinephrine and arachidonate, with the best correlation for those platelet aggregation assays in which intracellular signaling contributes to platelet aggregation. These findings support the development of the platelet function assay as an in vivo assay of platelet function.I finally got my hands on a frikkin' Nighbird yesterday 0b46394aab
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