A novel method to assess platelet inhibition by eptifibatide with thrombelastograph®

Nobuyuki Katori, Fania Szlam, Jerrold H. Levy, Kenichi A. Tanaka

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

We examined a novel method to detect platelet inhibition with thrombelastography (TEG®). We hypothesized that this method would be suitable for monitoring the antiplatelet effects of eptifibatide (Integrilin®). Whole blood from healthy volunteers was anticoagulated with 3.2% citrate or unfractionated heparin (7 IU/ mL). For the platelet aggregation test, both citrate and heparinized samples were spiked with increasing concentrations of eptifibatide (0, 0.2, 0.4, 0.8, 1.6, and 4 μg/mL). Conventional kaolin TEG® was performed with citrated samples, and batroxobin-modified TEG® was performed with heparinized samples, which were spiked with eptifibatide at concentrations of 0, 0.4, 0.8, 1.6, 4, 8, and 24 μg/mL. Adenosine 5′-diphosphate-induced platelet aggregation was reduced to 6.4% ± 2.9% (citrate) and 10.3% ± 4.8% (heparin) with eptifibatide at the concentration of 4 μg/mL. The kaolin TEG® showed a decrease in maximum amplitude (MA) only at the eptifibatide concentration of 24 μg/mL and no change in a angle, whereas with the batroxobin-based TEG®, the difference in MA and α angle was observed at concentrations ≥0.8 μg/mL. Additionally, the time to achieve maximum MA was much shorter for batroxobin TEG® than for kaolin TEG®. We conclude that the batroxobin-modified TEG® is a sensitive method that detects platelet inhibition induced by eptifibatide.

Original languageEnglish
Pages (from-to)1794-1799
Number of pages6
JournalAnesthesia and analgesia
Volume99
Issue number6
DOIs
Publication statusPublished - 2004 Dec

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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