Total Thrombus-Formation System in Patients with Peripheral Artery Disease

Abstract

The Total Thrombus-formation Analysis System (T-TAS) is an automated device using coated microchips to assess thrombus formation under flow conditions. Its value to monitor coagulation function in patients under antiplatelet therapy awaits further clarification. This study evaluated T-TAS to detect response to dual antiplatelet therapy (DAPT) in patients with peripheral artery disease (PAD).T-TAS using the platelet-chip (PL-chip) and atheroma-chip (AR-chip) was performed in 60 patients with PAD on the day after lower extremity revascularization. Results were compared with light transmission aggregometry (LTA) and multiple electrode aggregometry (MEA, ADP- and ASPI-test). To determine T-TAS reference ranges, 30 healthy blood donors were enrolled.The area under the curve of the PL-chip (AUC-PL) was outside the reference range in 91.2% and AUC-AR in 21.1% of the PAD patients. Low responders in MEA ASPI, MEA ADP or both tests and low responders in LTA induced by ADP had a significantly higher AUC-PL compared to responders (204 vs 70, p = .016 and 140 vs 32, p < .001), respectively. Median AUC-PL in low responders in LTA and MEA, LTA or MEA and in responders in LTA and MEA was 301, 104 and 32 (p = .001), respectively. Our results suggest that the PL-chip can continuously assess the level of response to DAPT and might be helpful to monitor PAD patients.

Keywords: T-TAS; antiplatelet monitoring; clopidogrel; dual antiplatelet therapy; peripheral artery disease.

Figure 1.

T-TAS parameters in patients with dual antiplatelet therapy and healthy blood donors.

Figure 2.

Correlation between T-TAS, LTA and MEA.

Figure 3.

Area under the curve of the PL-chip (AUC-PL) in dependence of the degree of platelet inhibition.