Abstract
Platelets play a key role in maintaining normal hemostasis and are also recognized
as partners in the development of arterial thrombosis. Today, platelet function testing
is used for very different clinical purposes; first, for investigation of platelet
dysfunction in acute bleeding and diagnosis of platelet disorders in patients with
long-lasting bleeding tendency, and second, for testing the efficacy of antiplatelet
therapy in patients with increased thromboembolic risk. Moreover, it has been discussed
whether platelet function testing can be used for prediction of bleeding risk (e.g.,
prior to major surgery). Ever since light transmission aggregometry was introduced,
laboratories around the world have worked on testing platelet function, and during
the last decades a wide range of new methods has emerged. Besides the clinical utility
of platelet function testing, the present review summarizes the test principles and
advantages and disadvantages of the different methods, depending on the purpose for
which it is to be used. A critical step in investigation of platelet function is the
preanalytical factors that can substantially affect test results. Therefore, this
review also provides an overview of preanalytical variables that range from patient-related
factors such as smoking, coffee, and exercise prior to blood sampling to selection
of anticoagulant, needle gauge, and time from blood sampling to analyses. Finally,
this review outlines further perspectives on platelet function testing for clinical
practice and for research purposes.
Keywords
platelets - platelet activation - platelet function tests - platelet disorders - preanalytical
