Evaluation of the clinical utility of platelet aggregation studies

A. T. Remaley, J. M. Kennedy, Michael Laposata

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

To determine the diagnostic importance of platelet aggregation studies, we evaluated the clinical utility of these assays by a retrospective review of 188 adult patients initially studied for bleeding abnormalities with platelet aggregation tests at a tertiary care hospital from 1984 to 1987. The primary indications for requesting the tests in our patient population were for the evaluation of a positive bleeding history or abnormal bleeding time (68%), hypercoagulability (17%), thrombocytosis (9%), or a family history of a bleeding disorder (6%). There was a statistically higher incidence of platelet aggregation test abnormalities in patients with highly abnormal bleeding times (40%), in patients with thrombocytosis from myeloproliferative disorders (65%), and in patients with a family history of a bleeding disorder (58%), compared to the other groups studied (16-29%). Of the 64 platelet aggregation tests performed that were abnormal, the following abnormalities were identified: 19 aspirin-like defects (poor response to arachidonate and decreased second wave responses to weak agonists), which were presumably drug-induced, ten myeloproliferative-type disorder defects (abnormal response to epinephrine predominantly) in patients known to have myeloproliferative disease, 34 abnormal patterns not characterized as aspirin or myeloproliferative disorder related, four of which ultimately led to a diagnosis of storage pool disease, and one spontaneous aggregation defect. Our results suggest that platelet aggregation tests rarely lead to the diagnosis of a specific, previously undiagnosed platelet function disorder. Specific recommendations are given for efficient utilization of platelet aggregation tests.

Original languageEnglish (US)
Pages (from-to)188-193
Number of pages6
JournalAmerican Journal of Hematology
Volume31
Issue number3
StatePublished - 1989
Externally publishedYes

Fingerprint

Platelet Aggregation
Myeloproliferative Disorders
Hemorrhage
Thrombocytosis
Bleeding Time
Aspirin
Thrombophilia
Tertiary Healthcare
Tertiary Care Centers
Epinephrine
Blood Platelets
Incidence
Pharmaceutical Preparations
Population

ASJC Scopus subject areas

  • Hematology

Cite this

Evaluation of the clinical utility of platelet aggregation studies. / Remaley, A. T.; Kennedy, J. M.; Laposata, Michael.

In: American Journal of Hematology, Vol. 31, No. 3, 1989, p. 188-193.

Research output: Contribution to journalArticle

Remaley, A. T. ; Kennedy, J. M. ; Laposata, Michael. / Evaluation of the clinical utility of platelet aggregation studies. In: American Journal of Hematology. 1989 ; Vol. 31, No. 3. pp. 188-193.
@article{50e395c361b14422bd8e6cfad114bad1,
title = "Evaluation of the clinical utility of platelet aggregation studies",
abstract = "To determine the diagnostic importance of platelet aggregation studies, we evaluated the clinical utility of these assays by a retrospective review of 188 adult patients initially studied for bleeding abnormalities with platelet aggregation tests at a tertiary care hospital from 1984 to 1987. The primary indications for requesting the tests in our patient population were for the evaluation of a positive bleeding history or abnormal bleeding time (68{\%}), hypercoagulability (17{\%}), thrombocytosis (9{\%}), or a family history of a bleeding disorder (6{\%}). There was a statistically higher incidence of platelet aggregation test abnormalities in patients with highly abnormal bleeding times (40{\%}), in patients with thrombocytosis from myeloproliferative disorders (65{\%}), and in patients with a family history of a bleeding disorder (58{\%}), compared to the other groups studied (16-29{\%}). Of the 64 platelet aggregation tests performed that were abnormal, the following abnormalities were identified: 19 aspirin-like defects (poor response to arachidonate and decreased second wave responses to weak agonists), which were presumably drug-induced, ten myeloproliferative-type disorder defects (abnormal response to epinephrine predominantly) in patients known to have myeloproliferative disease, 34 abnormal patterns not characterized as aspirin or myeloproliferative disorder related, four of which ultimately led to a diagnosis of storage pool disease, and one spontaneous aggregation defect. Our results suggest that platelet aggregation tests rarely lead to the diagnosis of a specific, previously undiagnosed platelet function disorder. Specific recommendations are given for efficient utilization of platelet aggregation tests.",
author = "Remaley, {A. T.} and Kennedy, {J. M.} and Michael Laposata",
year = "1989",
language = "English (US)",
volume = "31",
pages = "188--193",
journal = "American Journal of Hematology",
issn = "0361-8609",
publisher = "Wiley-Liss Inc.",
number = "3",

}

TY - JOUR

T1 - Evaluation of the clinical utility of platelet aggregation studies

AU - Remaley, A. T.

AU - Kennedy, J. M.

AU - Laposata, Michael

PY - 1989

Y1 - 1989

N2 - To determine the diagnostic importance of platelet aggregation studies, we evaluated the clinical utility of these assays by a retrospective review of 188 adult patients initially studied for bleeding abnormalities with platelet aggregation tests at a tertiary care hospital from 1984 to 1987. The primary indications for requesting the tests in our patient population were for the evaluation of a positive bleeding history or abnormal bleeding time (68%), hypercoagulability (17%), thrombocytosis (9%), or a family history of a bleeding disorder (6%). There was a statistically higher incidence of platelet aggregation test abnormalities in patients with highly abnormal bleeding times (40%), in patients with thrombocytosis from myeloproliferative disorders (65%), and in patients with a family history of a bleeding disorder (58%), compared to the other groups studied (16-29%). Of the 64 platelet aggregation tests performed that were abnormal, the following abnormalities were identified: 19 aspirin-like defects (poor response to arachidonate and decreased second wave responses to weak agonists), which were presumably drug-induced, ten myeloproliferative-type disorder defects (abnormal response to epinephrine predominantly) in patients known to have myeloproliferative disease, 34 abnormal patterns not characterized as aspirin or myeloproliferative disorder related, four of which ultimately led to a diagnosis of storage pool disease, and one spontaneous aggregation defect. Our results suggest that platelet aggregation tests rarely lead to the diagnosis of a specific, previously undiagnosed platelet function disorder. Specific recommendations are given for efficient utilization of platelet aggregation tests.

AB - To determine the diagnostic importance of platelet aggregation studies, we evaluated the clinical utility of these assays by a retrospective review of 188 adult patients initially studied for bleeding abnormalities with platelet aggregation tests at a tertiary care hospital from 1984 to 1987. The primary indications for requesting the tests in our patient population were for the evaluation of a positive bleeding history or abnormal bleeding time (68%), hypercoagulability (17%), thrombocytosis (9%), or a family history of a bleeding disorder (6%). There was a statistically higher incidence of platelet aggregation test abnormalities in patients with highly abnormal bleeding times (40%), in patients with thrombocytosis from myeloproliferative disorders (65%), and in patients with a family history of a bleeding disorder (58%), compared to the other groups studied (16-29%). Of the 64 platelet aggregation tests performed that were abnormal, the following abnormalities were identified: 19 aspirin-like defects (poor response to arachidonate and decreased second wave responses to weak agonists), which were presumably drug-induced, ten myeloproliferative-type disorder defects (abnormal response to epinephrine predominantly) in patients known to have myeloproliferative disease, 34 abnormal patterns not characterized as aspirin or myeloproliferative disorder related, four of which ultimately led to a diagnosis of storage pool disease, and one spontaneous aggregation defect. Our results suggest that platelet aggregation tests rarely lead to the diagnosis of a specific, previously undiagnosed platelet function disorder. Specific recommendations are given for efficient utilization of platelet aggregation tests.

UR - http://www.scopus.com/inward/record.url?scp=0024348558&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024348558&partnerID=8YFLogxK

M3 - Article

C2 - 2741911

AN - SCOPUS:0024348558

VL - 31

SP - 188

EP - 193

JO - American Journal of Hematology

JF - American Journal of Hematology

SN - 0361-8609

IS - 3

ER -