Which is the best anticoagulant for whole blood aggregometry platelet function testing Comparison of six anticoagulants and diverse storage conditions

摘要

Major hindrances of impedance aggregometry are caused by limited storage time and the requirement of ex vivo anticoagulation. Data on the influence of different anticoagulants and storage conditions are rare and incomplete. This study has systematically examined the influence of six different anticoagulants (sodium and lithium heparin, 20μg/mL and 45μg/mL r-hirudin, benzylsulfonyl-D-Arg-Pro-4-amidinobenzylamide (BAPA), and citrate) on the results of Adenosine 5′-diphosphate (ADP) and arachidonic acid (AA) induced measurements using multiple-electrode impedance aggregometer (MEA). Measurements were carried out in a time frame of 0min up to 48h after blood withdrawal. In addition, the influence of storage temperatures of 4°C and 37°C was evaluated. Results of ADP-induced tests significantly varied within the first 30min in all tested anticoagulants, in citrated blood even within the first 60min. They remained stable up to 2h in 20 μg/mL r-hirudin and BAPA, 4h in citrate, 8h in 45μg/mL r-hirudin, and lithium heparin and up to a maximum of 12h in sodium heparin anticoagulated blood. The analysis of AA-induced tests revealed no significantly different results up to 6h when BAPA was used, 8h in lithium heparin, 20μg/mL r-hirudin and citrate, 12h in 45μg/mL r-hirudin, and even 24h in sodium heparin-anticoagulated samples. A storage temperature of either 4°C or 37°C in contrast to room temperature had a negative influence on the stability of results. In conclusion, sodium heparin and 45μg/mL r-hirudin as anticoagulants guarantee the longest storage time for impedance aggregometry.