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Semin Thromb Hemost 2016; 42(03): 258-267
DOI: 10.1055/s-0035-1564834
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Platelet Function Tests

Marie Lordkipanidzé
1   Faculté de Pharmacie, Université de Montréal, Montréal, Québec, Canada
2   Research Center, Montreal Heart Institute, Montréal, Québec, Canada
› Author Affiliations
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Publication History

Publication Date:
29 February 2016 (online)

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Abstract

Traditionally developed for diagnosis of bleeding disorders, platelet function assays have become increasingly used in basic research on platelet physiology, in phenotype–genotype associations in bleeding disorders, in drug development as surrogate endpoints of efficacy of new antiplatelet therapy, and to an extent, in the monitoring of antiplatelet therapy in clinical practice to predict thrombotic and bleeding risk. A multiplicity of platelet function assays is available to measure the level of platelet activity in various settings. These include assays that are restricted to a specialized laboratory as well as point-of-care instruments meant to investigate platelet function at patient bedside. Unlike tests that determine a defined quantity or measurement of a clinical biomarker (e.g., cholesterol or blood pressure), platelet function testing assesses the dynamics of living cells, which immediately presents a series of unique problems to any laboratory or clinic. This article presents currently used platelet function assays and discusses important variables to take into account when performing these assays, including preanalytical issues and difficulties in interpreting platelet function test results.

Keywords

antiplatelet therapy - bleeding disorders - platelet function testing
 

  • References

  • 1 Nurden AT. Platelets, inflammation and tissue regeneration. Thromb Haemost 2011; 105 (Suppl. 01) S13-S33
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 McFadyen JD, Kaplan ZS. Platelets are not just for clots. Transfus Med Rev 2015; 29 (2) 110-119
    CrossrefPubMedSearch in Google Scholar
  • 3 Gremmel T, Frelinger III AL, Michelson AD. Platelet physiology. Semin Thromb Hemost 2016; 42 (3) 191-204
    Thieme ConnectPubMedSearch in Google Scholar
  • 4 Gresele P ; Subcommittee on Platelet Physiology. Diagnosis of inherited platelet function disorders: guidance from the SSC of the ISTH. J Thromb Haemost 2015; 13 (2) 314-322
    CrossrefPubMedSearch in Google Scholar
  • 5 Gawaz M, Langer H, May AE. Platelets in inflammation and atherogenesis. J Clin Invest 2005; 115 (12) 3378-3384
    CrossrefPubMedSearch in Google Scholar
  • 6 Ruggeri ZM. Platelets in atherothrombosis. Nat Med 2002; 8 (11) 1227-1234
    CrossrefPubMedSearch in Google Scholar
  • 7 Siller-Matula JM, Trenk D, Schrör K , et al; European Platelet Academy. How to improve the concept of individualised antiplatelet therapy with P2Y12 receptor inhibitors—is an algorithm the answer?. Thromb Haemost 2015; 113 (1) 37-52
    PubMedSearch in Google Scholar
  • 8 Petricevic M, Kopjar T, Biocina B , et al. The predictive value of platelet function point-of-care tests for postoperative blood loss and transfusion in routine cardiac surgery: a systematic review. Thorac Cardiovasc Surg 2015; 63 (1) 2-20
    PubMedSearch in Google Scholar
  • 9 Gresele P, Bury L, Falcinelli E. Inherited platelet function disorders: algorithms for phenotypic and genetic investigation. Semin Thromb Hemost 2016; 42 (3) 292-305
    Thieme ConnectPubMedSearch in Google Scholar
  • 10 Cai H, Mullier F, Frotscher B , et al. Usefulness of flow cytometric mepacrine uptake/release combined with CD63 assay in diagnosis of patients with suspected platelet dense granule disorder. Semin Thromb Hemost 2016; 42 (3) 282-291
    Thieme ConnectPubMedSearch in Google Scholar
  • 11 Gross L, Aradi D, Sibbing D. Platelet function testing in patients on antiplatelet medications. Semin Thromb Hemost 2016; 42 (3) 306-320
    Thieme ConnectPubMedSearch in Google Scholar
  • 12 Milian MG. Technique pour l'étude clinique de la coagulation du sang. Bull Mem Soc Med Hop Paris 1901; 18: 777-783
    PubMedSearch in Google Scholar
  • 13 Duke WW. The relation of blood platelets to hemorrhagic disease. Description of a method for determining the bleeding time and the coagulation time and report of three cases of hemorrahagic disease relieved by blood transfusion. JAMA 1910; 55: 1185-1192
    CrossrefPubMedSearch in Google Scholar
  • 14 Ivy AC, Nelson D, Bucher G. The standardization of certain factors in the cutaneous “venostasis” bleeding time technique. J Lab Clin Med 1941; 26: 1812-1822
    PubMedSearch in Google Scholar
  • 15 Mielke Jr CH, Kaneshiro MM, Maher IA, Weiner JM, Rapaport SI. The standardized normal Ivy bleeding time and its prolongation by aspirin. Blood 1969; 34 (2) 204-215
    PubMedSearch in Google Scholar
  • 16 The British Society for Haematology BCSH Haemostasis and Thrombosis Task Force. Guidelines on platelet function testing. J Clin Pathol 1988; 41 (12) 1322-1330
    CrossrefPubMedSearch in Google Scholar
  • 17 Rodgers RP, Levin J. A critical reappraisal of the bleeding time. Semin Thromb Hemost 1990; 16 (1) 1-20
    Thieme ConnectPubMedSearch in Google Scholar
  • 18 Lind SE. The bleeding time does not predict surgical bleeding. Blood 1991; 77 (12) 2547-2552
    CrossrefPubMedSearch in Google Scholar
  • 19 Peterson P, Hayes TE, Arkin CF , et al. The preoperative bleeding time test lacks clinical benefit: College of American Pathologists' and American Society of Clinical Pathologists' position article. Arch Surg 1998; 133 (2) 134-139
    CrossrefPubMedSearch in Google Scholar
  • 20 Harrison P, Mackie I, Mumford A , et al; British Committee for Standards in Haematology. Guidelines for the laboratory investigation of heritable disorders of platelet function. Br J Haematol 2011; 155 (1) 30-44
    CrossrefPubMedSearch in Google Scholar
  • 21 Moffat KA, Ledford-Kraemer MR, Nichols WL, Hayward CP ; North American Specialized Coagulation Laboratory Association. Variability in clinical laboratory practice in testing for disorders of platelet function: results of two surveys of the North American Specialized Coagulation Laboratory Association. Thromb Haemost 2005; 93 (3) 549-553
    PubMedSearch in Google Scholar
  • 22 Jennings I, Woods TA, Kitchen S, Walker ID. Platelet function testing: practice among UK National External Quality Assessment Scheme for Blood Coagulation participants, 2006. J Clin Pathol 2008; 61 (8) 950-954
    CrossrefPubMedSearch in Google Scholar
  • 23 Cattaneo M, Hayward CP, Moffat KA, Pugliano MT, Liu Y, Michelson AD. Results of a worldwide survey on the assessment of platelet function by light transmission aggregometry: a report from the platelet physiology subcommittee of the SSC of the ISTH. J Thromb Haemost 2009; 7 (6) 1029
    CrossrefPubMedSearch in Google Scholar
  • 24 Gresele P, Harrison P, Bury L , et al. Diagnosis of suspected inherited platelet function disorders: results of a worldwide survey. J Thromb Haemost 2014; 12 (9) 1562-1569
    CrossrefPubMedSearch in Google Scholar
  • 25 Favaloro EJ. Time for a conceptual shift in assessment of internal quality control for whole blood or cell-based testing systems? An evaluation using platelet function and the PFA-100 as a case example. Clin Chem Lab Med 2013; 51 (4) 767-774
    PubMedSearch in Google Scholar
  • 26 Favaloro EJ, Bonar R. External quality assessment/proficiency testing and internal quality control for the PFA-100 and PFA-200: an update. Semin Thromb Hemost 2014; 40 (2) 239-253
    Thieme ConnectPubMedSearch in Google Scholar
  • 27 Favaloro EJ. Internal quality control and external quality assurance of platelet function tests. Semin Thromb Hemost 2009; 35 (2) 139-149
    Thieme ConnectPubMedSearch in Google Scholar
  • 28 Harrison P, Lordkipanidzé M. Testing platelet function. Hematol Oncol Clin North Am 2013; 27 (3) 411-441
    CrossrefPubMedSearch in Google Scholar
  • 29 Hartley PS. The diurnal tick-tockery of platelet biology. Platelets 2012; 23 (2) 157-160
    CrossrefPubMedSearch in Google Scholar
  • 30 Davis RB, Boyd DG, McKinney ME, Jones CC. Effects of exercise and exercise conditioning on blood platelet function. Med Sci Sports Exerc 1990; 22 (1) 49-53
    PubMedSearch in Google Scholar
  • 31 Ahuja KD, Adams MJ, Robertson IK, Ball MJ. Acute effect of a high-carbohydrate low-fat meal on platelet aggregation. Platelets 2009; 20 (8) 606-609
    CrossrefPubMedSearch in Google Scholar
  • 32 Natella F, Nardini M, Belelli F , et al. Effect of coffee drinking on platelets: inhibition of aggregation and phenols incorporation. Br J Nutr 2008; 100 (6) 1276-1282
    CrossrefPubMedSearch in Google Scholar
  • 33 Varani K, Portaluppi F, Gessi S , et al. Dose and time effects of caffeine intake on human platelet adenosine A(2A) receptors : functional and biochemical aspects. Circulation 2000; 102 (3) 285-289
    CrossrefPubMedSearch in Google Scholar
  • 34 Rival J, Riddle JM, Stein PD. Effects of chronic smoking on platelet function. Thromb Res 1987; 45 (1) 75-85
    PubMedSearch in Google Scholar
  • 35 Kottke-Marchant K, Corcoran G. The laboratory diagnosis of platelet disorders. Arch Pathol Lab Med 2002; 126 (2) 133-146
    PubMedSearch in Google Scholar
  • 36 Cattaneo M, Cerletti C, Harrison P , et al. Recommendations for the standardization of light transmission aggregometry: A consensus of the working party from the platelet physiology subcommittee of SSC/ISTH. J Thromb Haemost 2013; 11: 1183-1189
    CrossrefPubMedSearch in Google Scholar
  • 37 Favaloro EJ, Lippi G, Adcock DM. Preanalytical and postanalytical variables: the leading causes of diagnostic error in hemostasis?. Semin Thromb Hemost 2008; 34 (7) 612-634
    Thieme ConnectPubMedSearch in Google Scholar
  • 38 Kaiser AF, Neubauer H, Franken CC, Krüger JC, Mügge A, Meves SH. Which is the best anticoagulant for whole blood aggregometry platelet function testing? Comparison of six anticoagulants and diverse storage conditions. Platelets 2012; 23 (5) 359-367
    CrossrefPubMedSearch in Google Scholar
  • 39 Thalén S, Forsling I, Eintrei J, Söderblom L, Antovic JP. Pneumatic tube transport affects platelet function measured by multiplate electrode aggregometry. Thromb Res 2013; 132 (1) 77-80
    CrossrefPubMedSearch in Google Scholar
  • 40 Femia EA, Pugliano M, Podda G, Cattaneo M. Comparison of different procedures to prepare platelet-rich plasma for studies of platelet aggregation by light transmission aggregometry. Platelets 2012; 23 (1) 7-10
    CrossrefPubMedSearch in Google Scholar
  • 41 Linnemann B, Schwonberg J, Mani H, Prochnow S, Lindhoff-Last E. Standardization of light transmittance aggregometry for monitoring antiplatelet therapy: an adjustment for platelet count is not necessary. J Thromb Haemost 2008; 6 (4) 677-683
    CrossrefPubMedSearch in Google Scholar
  • 42 Cattaneo M, Lecchi A, Zighetti ML, Lussana F. Platelet aggregation studies: autologous platelet-poor plasma inhibits platelet aggregation when added to platelet-rich plasma to normalize platelet count. Haematologica 2007; 92 (5) 694-697
    CrossrefPubMedSearch in Google Scholar
  • 43 Born GV. Aggregation of blood platelets by adenosine diphosphate and its reversal. Nature 1962; 194: 927-929
    PubMedSearch in Google Scholar
  • 44 Pai M, Wang G, Moffat KA , et al. Diagnostic usefulness of a lumi-aggregometer adenosine triphosphate release assay for the assessment of platelet function disorders. Am J Clin Pathol 2011; 136 (3) 350-358
    CrossrefPubMedSearch in Google Scholar
  • 45 Hayward CP, Moffat KA, Raby A , et al. Development of North American consensus guidelines for medical laboratories that perform and interpret platelet function testing using light transmission aggregometry. Am J Clin Pathol 2010; 134 (6) 955-963
    CrossrefPubMedSearch in Google Scholar
  • 46 Cazenave JP, Ohlmann P, Cassel D, Eckly A, Hechler B, Gachet C. Preparation of washed platelet suspensions from human and rodent blood. Methods Mol Biol 2004; 272: 13-28
    PubMedSearch in Google Scholar
  • 47 Dawood BB, Lowe GC, Lordkipanidzé M , et al. Evaluation of participants with suspected heritable platelet function disorders including recommendation and validation of a streamlined agonist panel. Blood 2012; 120 (25) 5041-5049
    CrossrefPubMedSearch in Google Scholar
  • 48 Lawrie AS, Kobayashi K, Lane PJ, Mackie IJ, Machin SJ. The automation of routine light transmission platelet aggregation. Int J Lab Hematol 2014; 36 (4) 431-438
    CrossrefPubMedSearch in Google Scholar
  • 49 Sun B, Tandon NN, Yamamoto N, Yoshitake M, Kambayashi J. Luminometric assay of platelet activation in 96-well microplate. Biotechniques 2001; 31 (5) 1174 , 1176, 1178 passim
    PubMedSearch in Google Scholar
  • 50 Moran N, Kiernan A, Dunne E, Edwards RJ, Shields DC, Kenny D. Monitoring modulators of platelet aggregation in a microtiter plate assay. Anal Biochem 2006; 357 (1) 77-84
    CrossrefPubMedSearch in Google Scholar
  • 51 Chan MV, Armstrong PC, Papalia F, Kirkby NS, Warner TD. Optical multichannel (optimul) platelet aggregometry in 96-well plates as an additional method of platelet reactivity testing. Platelets 2011; 22 (7) 485-494
    CrossrefPubMedSearch in Google Scholar
  • 52 Chan MV, Warner TD. Standardised optical multichannel (optimul) platelet aggregometry using high-speed shaking and fixed time point readings. Platelets 2012; 23 (5) 404-408
    CrossrefPubMedSearch in Google Scholar
  • 53 Lordkipanidzé M, Lowe GC, Kirkby NS , et al; UK Genotyping and Phenotyping of Platelets Study Group. Characterization of multiple platelet activation pathways in patients with bleeding as a high-throughput screening option: use of 96-well Optimul assay. Blood 2014; 123 (8) e11-e22
    CrossrefPubMedSearch in Google Scholar
  • 54 Mylotte D, Kavanagh GF, Peace AJ , et al. Platelet reactivity in type 2 diabetes mellitus: a comparative analysis with survivors of myocardial infarction and the role of glycaemic control. Platelets 2012; 23 (6) 439-446
    CrossrefPubMedSearch in Google Scholar
  • 55 Cooke NM, Egan K, McFadden S , et al. Increased platelet reactivity in patients with late-stage metastatic cancer. Cancer Med 2013; 2 (4) 564-570
    CrossrefPubMedSearch in Google Scholar
  • 56 Cardinal DC, Flower RJ. The electronic aggregometer: a novel device for assessing platelet behavior in blood. J Pharmacol Methods 1980; 3 (2) 135-158
    CrossrefPubMedSearch in Google Scholar
  • 57 Solomon C, Traintinger S, Ziegler B , et al. Platelet function following trauma. A multiple electrode aggregometry study. Thromb Haemost 2011; 106 (2) 322-330
    Thieme ConnectPubMedSearch in Google Scholar
  • 58 Valarche V, Desconclois C, Boutekedjiret T, Dreyfus M, Proulle V. Multiplate whole blood impedance aggregometry: a new tool for von Willebrand disease. J Thromb Haemost 2011; 9 (8) 1645-1647
    CrossrefPubMedSearch in Google Scholar
  • 59 Aradi D, Storey RF, Komócsi A , et al; Working Group on Thrombosis of the European Society of Cardiology. Expert position paper on the role of platelet function testing in patients undergoing percutaneous coronary intervention. Eur Heart J 2014; 35 (4) 209-215
    CrossrefPubMedSearch in Google Scholar
  • 60 Würtz M, Hvas AM, Christensen KH, Rubak P, Kristensen SD, Grove EL. Rapid evaluation of platelet function using the Multiplate® Analyzer. Platelets 2014; 25 (8) 628-633
    CrossrefPubMedSearch in Google Scholar
  • 61 Rubak P, Villadsen K, Hvas AM. Reference intervals for platelet aggregation assessed by multiple electrode platelet aggregometry. Thromb Res 2012; 130 (3) 420-423
    CrossrefPubMedSearch in Google Scholar
  • 62 Stissing T, Dridi NP, Ostrowski SR, Bochsen L, Johansson PI. The influence of low platelet count on whole blood aggregometry assessed by Multiplate. Clin Appl Thromb Hemost 2011; 17 (6) E211-E217
    CrossrefPubMedSearch in Google Scholar
  • 63 Kong R, Trimmings A, Hutchinson N , et al. Consensus recommendations for using the Multiplate(®) for platelet function monitoring before cardiac surgery. Int J Lab Hematol 2015; 37 (2) 143-147
    CrossrefPubMedSearch in Google Scholar
  • 64 Albanyan A, Al-Musa A, AlNounou R , et al. Diagnosis of Glanzmann thrombasthenia by whole blood impedance analyzer (MEA) vs. light transmission aggregometry. Int J Lab Hematol 2015; 37 (4) 503-508
    CrossrefPubMedSearch in Google Scholar
  • 65 Wang JC, Aucoin-Barry D, Manuelian D , et al. Incidence of aspirin nonresponsiveness using the Ultegra Rapid Platelet Function Assay-ASA. Am J Cardiol 2003; 92 (12) 1492-1494
    CrossrefPubMedSearch in Google Scholar
  • 66 van Werkum JW, Harmsze AM, Elsenberg EH, Bouman HJ, ten Berg JM, Hackeng CM. The use of the VerifyNow system to monitor antiplatelet therapy: a review of the current evidence. Platelets 2008; 19 (7) 479-488
    CrossrefPubMedSearch in Google Scholar
  • 67 Scavone M, Germanovich K, Femia EA, Cattaneo M. Usefulness of the INNOVANCE PFA P2Y test cartridge for the detection of patients with congenital defects of the platelet P2Y12 receptor for adenosine diphosphate. Thromb Res 2014; 133 (2) 254-256
    CrossrefPubMedSearch in Google Scholar
  • 68 Koessler J, Ehrenschwender M, Kobsar A, Brunner K. Evaluation of the new INNOVANCE® PFA P2Y cartridge in patients with impaired primary haemostasis. Platelets 2012; 23 (8) 571-578
    CrossrefPubMedSearch in Google Scholar
  • 69 Koessler J, Kobsar AL, Rajkovic MS , et al. The new INNOVANCE® PFA P2Y cartridge is sensitive to the detection of the P2Y12 receptor inhibition. Platelets 2011; 22 (1) 20-27
    PubMedSearch in Google Scholar
  • 70 Edwards A, Jakubowski JA, Rechner AR, Sugidachi A, Harrison P. Evaluation of the INNOVANCE PFA P2Y test cartridge: sensitivity to P2Y(12) blockade and influence of anticoagulant. Platelets 2012; 23 (2) 106-115
    CrossrefPubMedSearch in Google Scholar
  • 71 Carcao MD, Blanchette VS, Stephens D , et al. Assessment of thrombocytopenic disorders using the Platelet Function Analyzer (PFA-100). Br J Haematol 2002; 117 (4) 961-964
    CrossrefPubMedSearch in Google Scholar
  • 72 Cho YU, Jang S, Park CJ, Chi HS. Variables that affect platelet function analyzer-100 (PFA-100) closure times and establishment of reference intervals in Korean adults. Ann Clin Lab Sci 2008; 38 (3) 247-253
    PubMedSearch in Google Scholar
  • 73 Jilma B. Platelet function analyzer (PFA-100): a tool to quantify congenital or acquired platelet dysfunction. J Lab Clin Med 2001; 138 (3) 152-163
    CrossrefPubMedSearch in Google Scholar
  • 74 Favaloro EJ. Clinical application of the PFA-100. Curr Opin Hematol 2002; 9 (5) 407-415
    CrossrefPubMedSearch in Google Scholar
  • 75 Favaloro EJ. Clinical utility of the PFA-100. Semin Thromb Hemost 2008; 34 (8) 709-733
    Thieme ConnectPubMedSearch in Google Scholar
  • 76 Hayward CP, Harrison P, Cattaneo M, Ortel TL, Rao AK ; Platelet Physiology Subcommittee of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Platelet function analyzer (PFA)-100 closure time in the evaluation of platelet disorders and platelet function. J Thromb Haemost 2006; 4 (2) 312-319
    CrossrefPubMedSearch in Google Scholar
  • 77 Chen A, Teruya J. Global hemostasis testing thromboelastography: old technology, new applications. Clin Lab Med 2009; 29 (2) 391-407
    CrossrefPubMedSearch in Google Scholar
  • 78 Luddington RJ. Thromboelastography/thromboelastometry. Clin Lab Haematol 2005; 27 (2) 81-90
    CrossrefPubMedSearch in Google Scholar
  • 79 Blais N, Pharand C, Lordkipanidzé M, Sia YK, Merhi Y, Diodati JG. Response to aspirin in healthy individuals. Cross-comparison of light transmission aggregometry, VerifyNow system, platelet count drop, thromboelastography (TEG) and urinary 11-dehydrothromboxane B(2). Thromb Haemost 2009; 102 (2) 404-411
    Thieme ConnectPubMedSearch in Google Scholar
  • 80 Scharbert G, Auer A, Kozek-Langenecker S. Evaluation of the Platelet Mapping Assay on rotational thromboelastometry ROTEM. Platelets 2009; 20 (2) 125-130
    CrossrefPubMedSearch in Google Scholar
  • 81 Chitlur M, Lusher J. Standardization of thromboelastography: values and challenges. Semin Thromb Hemost 2010; 36 (7) 707-711
    Thieme ConnectPubMedSearch in Google Scholar
  • 82 Ramström S, Södergren AL, Tynngård N, Lindahl TL. Platelet function determined by flow cytometry: new perspectives?. Semin Thromb Hemost 2016; 42 (3) 268-281
    Thieme ConnectPubMedSearch in Google Scholar
  • 83 Rubak P, Nissen PH, Kristensen SD, Hvas AM. Investigation of platelet function and platelet disorders using flow cytometry. Platelets 2016; 27 (1) 66-74
    CrossrefPubMedSearch in Google Scholar
  • 84 Schmitz G, Rothe G, Ruf A , et al. European Working Group on Clinical Cell Analysis: Consensus protocol for the flow cytometric characterisation of platelet function. Thromb Haemost 1998; 79 (5) 885-896
    PubMedSearch in Google Scholar
  • 85 Matzdorff A. Platelet function tests and flow cytometry to monitor antiplatelet therapy. Semin Thromb Hemost 2005; 31 (4) 393-399
    Thieme ConnectPubMedSearch in Google Scholar
  • 86 Frelinger III AL, Grace RF, Gerrits AJ , et al. Platelet function tests, independent of platelet count, are associated with bleeding severity in ITP. Blood 2015; 126 (7) 873-879
    CrossrefPubMedSearch in Google Scholar
  • 87 Lee JA, Spidlen J, Boyce K , et al; International Society for Advancement of Cytometry Data Standards Task Force. MIFlowCyt: the minimum information about a Flow Cytometry Experiment. Cytometry A 2008; 73 (10) 926-930
    PubMedSearch in Google Scholar
  • 88 Coller BS. Historical perspective and future directions in platelet research. J Thromb Haemost 2011; 9 (Suppl. 01) 374-395
    CrossrefPubMedSearch in Google Scholar
  • 89 Michelson AD. Antiplatelet therapies for the treatment of cardiovascular disease. Nat Rev Drug Discov 2010; 9 (2) 154-169
    CrossrefPubMedSearch in Google Scholar
  • 90 Aradi D, Kirtane A, Bonello L , et al. Bleeding and stent thrombosis on P2Y12-inhibitors: collaborative analysis on the role of platelet reactivity for risk stratification after percutaneous coronary intervention. Eur Heart J 2015; 36 (27) 1762-1771
    CrossrefPubMedSearch in Google Scholar
  • 91 de Witt SM, Swieringa F, Cavill R , et al. Identification of platelet function defects by multi-parameter assessment of thrombus formation. Nat Commun 2014; 5: 4257
    PubMedSearch in Google Scholar