1. Monitoring platelet function using the Multiplate® analyzer
ASA
500 mg
i.v.

2. antiplatelet medications are given to a large number of patients
> Status Quo in most clinics
Tirofiban
Clopidogrel
Aspirin
Clopidogrel
Clopidogrel
Clopidogrel
Aspirin
Aspirin
Clopidogrel
Aspirin
antiplatelet medications are given to a large number of patients
in most clinics no monitoring of antiplatelet therapy is performed
Aspirin
Integrillin
Aspirin
Abciximab
Clopidogrel
Abciximab
Aspirin
Tirofiban
Integrillin

3. Platelet Function Analysis Market
simple
whole-blood-based
1-3 different tests single channel
high test price
complicated
low standardisation
used in research and reference labs
cartridge-based
platelet function
tests
born aggregation
flow cytometry

4. Platelet Function Analysis Market Multiplate ®
simple
whole-blood-based
1-3 different tests single channel
high test price
complicated
low standardisation
used in research and reference labs
Multiplate ®
easy-to-use
multi-channel
several tests available
open system
cartridge-based
platelet function
tests
born aggregation
flow cytometry

5. > principle of Multiplate® analysis
firm adhesion and aggregation of platelets on the sensor surface enhances the electrical resistance between the 2 sensor wires

6. > Multiplate® instrument
multiple
platelet
function
analyzer
Compact (10“ x 15“ x 4“)
5 independent channels
Integrated computer
Windows XP based software
Automatic pipetting optionally available

7. 2 sensors with 2 electrodes each
> Multiplate® test cell
2 sensors with 2 electrodes each
pipetting inlet
cup
plug portion
PTFE-coated stirrer

8. > Multiplate ® - Parameters
velocity
aggregation [AU]
time [min]
aggregation
Area under the curve = AUC 20 40 60 80
100
120
140
160 1 2 3 4 5
test 1
test 2 6
test 1+2

9. > Multiplate® test procedures
TRAPtest
TRAP
ADPtest
Clopidogrel
Prasugrel
Cangrelor
activation
TXA2
ADP
inhibition
COLtest
Collagen
PGE1
ADPtest HS
(ADP + PGE1)
1 release of arachidonic acid
ArA1
TXA2
GpIIb/IIIa antagonists:
Reopro ® (abciximab)
Aggrastat ® (Tirofiban)
Integrillin ® (Eptifibatid)
COX
ASPItest
Arachidonic
Acid
Aspirin ®
NSAR
platelet activation
GpIIb /IIIa receptor
exposure
degranulation :

10. - + PGE1 ADP Clopidogrel Activation Receptor exposure
>ADPtest HS: ADP + Prostaglandin E1
PGE1
ADP
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
Ca2+
cAMP
Clopidogrel - +
cAMP
Ca2+
Binding of ADP to the P2Y12 receptor lowers cAMP and enhances release of Ca2+ from intracellular stores (+). Plavix interferes with this interaction. PGE1 binds to the platelet and raises cAMP which reduces Ca2+ mobilisation (-).
Activation
Receptor exposure