Comparison of venous and arterial blood sampling for the assessment of platelet aggregation with whole blood impedance aggregometry

Abstract

Platelet monitoring is presently under evaluation in the clinic as a tool to improve antiplatelet treatment in patients with coronary artery disease (CAD). Measuring platelet function has, however, many inherent problems. It is important not only to evaluate the method used, but also to evaluate and standardize sampling and sample handling. As platelet monitoring is often performed in connection to coronary angiography and percutaneous coronary interventions, arterial sampling may be more convenient. However, in the outpatient follow-up setting venous sampling is, for obvious reasons, more practical and convenient. In the present study we compared platelet aggregation in blood collected from the arterial sheath to blood collected from the antecubital vein using multiple electrode aggregometry in whole blood in 28 patients with CAD. We found that sampling from artery and vein give similar data and that an identical number of patients with insufficient antiplatelet responses (‘low responders’ to aspirin and clopidogrel, respectively, according to predefined criteria) were detected with respect to adenosine diphosphate induced and arachidonic-acid induced aggregation. Thus both arterial and venous blood samples can be used in the monitoring of platelet function when multiple electrode aggregometry is applied to detect ‘low responders’.

Key Words::

• Clopidogrel
• aspirin
• percutaneous coronary intervention
• coronary artery disease
• impedance aggregometry
• venous blood and arterial blood

Acknowledgements

This work was supported by the Karolinska Institutet Fund 176, the Capio Research Foundation, through the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and the Karolinska Institutet, by Triolab AB and through a grant from Sanofi-aventis AB in Sweden.

The authors gratefully acknowledge the expert technical assistance of Joachim Lind, Marie Arvidsson and Thomas Kajander.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.