Thrombelastography and Other Novel Techniques
Recent implementation of user-friendly, point-of-care (POC) and near-POC platelet function assays in translational research studies enhanced interest in the personalized antiplatelet therapy concept. In addition to the measurement of platelet response to a particular agonist as measured in widely used POC platelet function assays, analyses of thrombin generation and viscoelastic characteristics of platelet-fibrin clot generation may enhance the prognostic value of the functional test. Thrombelastograph refers to the graphic display produced from measurement of the viscoelastic properties of platelet-fibrin clot generated in the whole blood under conditions of low shear. High maximum thrombin-induced platelet-fibrin clot strength and also high ADP-induced platelet-fibrin clot strength were shown to be associated with postpercutaneous coronary intervention ischemic event occurrences. Currently, there are other novel techniques under development that utilize hemodynamics, microfluidics, and nanotechnology principles such as CORA system, T2 magnetic resonance (T2MR), and shear-induced platelet aggregation assays (SIPA).