Changes in coagulation and platelet functions in patients with coronary atherosclerosis receiving oral administration of aspirin monitored by the in vitro coagulation dynamic detection sensor
Authors: Chen Qimeng , Li Zibo , Liu Ziqi , Wu Qiong , Wang Zhe 
Published: April 2021

Abstract
To solve the problem of monitoring the platelet functions in different stages during the arterial thrombosis process in a real-time and dynamic manner, this study aimed to propose a dual-channel in vitro coagulation dynamic whole-process detection sensing system to continuously monitor the changes in coagulation and platelet functions in patients with coronary atherosclerosis receiving oral administration of aspirin. Altogether 20 healthy subjects were randomly selected from the physical examination center. In addition, 20 patients with the initial diagnosis of coronary atherosclerosis who were naive to any antiplatelet drug therapy were also enrolled. After admission, the patients were administered with aspirin at 100 mg/day. For the healthy group, one single venous blood sample was collected from each of them. For the inpatients, they were given corresponding antiplatelet drug therapy, and venous blood samples were collected before administration (0 h), and at 6 h (6 h), 12 h (12 h), 18 h (18 h) and 24 h (24 h) after administration, respectively. Each blood sample was collected into the sodium citrate-containing anticoagulant blood collection tube. After each collection, the in vitro coagulation dynamic detection sensing system was used to detect each indicator. In the dual-channel in vitro coagulation dynamic whole-process detection sensing system developed in this study, one channel served as the experimental channel for patients with coronary atherosclerosis, which adopted the dry coagulation glass bead kit developed in this paper, where the thrombin was directly activated by the glass bead, and it was denoted as the nor channel. The other channel served as the blank control channel for the experimental channel, which adopted the dry coagulation glass bead kit developed in this study and was denoted as the non-channel. The normally distributed measurement data were expressed as means ± SD (x ̅±s) and compared by student’s t-test between two groups. Analysis of variance (ANOVA) was applied in comparisons before and after treatment (in the case of homogeneity of variance, the LSD method was applied in analysis; otherwise, the Dunnett’s C method was used for analysis). A difference of P<0.05 indicated statistical significance. ① Changes in the values of diverse parameters of nor-channel and non-channel in patients with coronary atherosclerosis before administration were different from the normal levels. On the whole, before administration, the activated clotting time (ACT) decreased, clot rate (CR) increased, and platelet factor (PF) increased, suggesting the abnormal platelet function in the blood of patients with coronary atherosclerosis. Meanwhile, after oral administration of aspirin, the changes in nor-channel showed not significant difference, indirectly indicating that the glass bead dry coagulation reagent developed in our previous study was the best coagulation activator. ② Patients with coronary atherosclerosis took aspirin for a long time (100 mg/day), and the maximum dose after admission was 300 mg/day. In these patients, the ACT increased, CR decreased, and PF declined. These changes were not significantly different compared with normal levels, suggesting that the increased dose was acceptable to patients, which might be used to guide clinical treatment. ③ For patients with the initial diagnosis of coronary atherosclerosis, the nor-channel and non-channel data were significantly different after oral administration of aspirin (100 mg/day). To be specific, ACT increased, CR decreased, and PF declined. The PF changes were not consistent with our expectation, but they might be ascribed to the small sample size, thus indirectly reflecting that thrombin activation by glass beads was the rapidest and best approach among the platelet activation pathways, which more sensitively and accurately evaluated the indicators for aspirin efficacy. This paper develops a new method to evaluate the in vitro antiplatelet drug efficacy based on the blood viscoelastic test. This method can evaluate platelet function in a rapider and easier manner; besides, it allows for the use of diverse bedside techniques, thereby displaying great application prospect in medicine and biomedical engineering.