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BACKGROUND: We determined whether whole blood impedance aggregometry using the Multiplate® detects the effects of antiplatelet drugs as reliably as does classical light transmission aggregometry (LTA) or the platelet function analyzer PFA-100®.

METHODS: Multiplate (M) assays, measuring changes in electrical resistance as aggregation units over time (AU*min), and LTA assays induced by collagen (COL), adenosine diphosphate (ADP) or arachidonic acid (AA) and PFA-100 testing, using epinephrine (PFA100-EPI) or ADP (PFA100-ADP) cartridges, were performed simultaneously using arterial blood samples obtained before induction of anesthesia in 70 consecutive patients scheduled for elective coronary artery bypass grafting. Patients in group A (n = 48) served as controls, patients in group B (n = 11) received aspirin 100 mg/d and those in group C (n = 11) aspirin 100 mg/d and clopidogrel 75 mg/d until the day before surgery.

RESULTS: In controls the median (1st, 3rd quartiles) change in impedance AU*min for M-COL (374 [231–469]) was significantly greater than in patients receiving aspirin (164 [86–211], P = 0.0009) or receiving aspirin and clopidogrel (118 [101–244], P = 0.004). M-ADP values in controls were 258 (158–389), in patients receiving aspirin 261 (159–393), and in patients receiving aspirin and clopidogrel 88 (48–231, P = 0.054). M-AA values were significantly lower in patients receiving aspirin alone (45 [28–60], P = 0.0004) or aspirin and clopidogrel (44 [26–221], P = 0.008) than in controls (200 [86–345]).

The areas under the receiver operating characteristic curves indicating the ability to discriminate patients taking aspirin from those not taking aspirin were comparable for COL and AA assays using whole blood impedance aggregometry or classical LTA (M-COL 0.84 [P = 0.001], LTA-COL 0.85 [P = < .001], M-AA 0.84 [P = < .001] and LTA-AA 0.87 [P = < .001]), but only 0.74 for PFA-100-EPI (P = 0.03). Similarly, for discrimination of patients not taking antiplatelet drugs from patients taking clopidogrel and aspirin the areas under the receiver operating characteristic curve were also comparable for both aggregometry methods M-COL 0.77 (P = 0.006), LTA-COL 0.78 (P = 0.004), M-ADP 0.74 (P = 0.015), LTA-ADP 0.73 (P = 0.018).

CONCLUSION: Results achieved with the bedside Multiplate assays were not different than those obtained with classical aggregometry for detecting the effects of aspirin and clopidogrel in preoperative patients scheduled for elective cardiac surgery.

Ocean An Illustrated Atlas
Written by Sylvia A. Earle and Linda K. Glover

Detailing a mysterious realm that’s as vital to our existence as the air we breathe, this new atlas immerses readers in the wonders of the deep through more than 250 up-to-the-minute maps, photographs, and satellite images. Deep-sea pioneer and National Geographic Explorer-in-Residence Sylvia A. Earle (known as "Her Deepness") and marine scientist Linda K. Glover guide the adventure, in consultation with experts from NASA and the National Oceanic and Atmospheric Administration—who welcome the publication of a comprehensive ocean atlas geared to popular readers.

The accessible text lays out key concepts, points of interest, and little known facts, opening our eyes to living phenomena from giant squid to tiny microbial bodies. Astonishing full-color photographs and diagrams reveal the beauty and complexity of ocean life. Unprecedented new full spread maps of the ocean floor—hand-drawn by expert cartographers—reveal the five major oceans in astonishing details. An unequaled resource for both education and entertainment, Ocean also explores the progress of fascinating technologies that will help scientists discover uncharted regions and life-forms. In light of recent events—the tsunami of 2004, Katrina and Rita of 2005, the growth of the ozone hole—humankind’s link to the ocean is front and center in our lives today. This rich informative, and timely atlas, encourages understanding of how the ocean correlates with these happenings—and how human maintenance of its waters and creatures will keep the planet going.