Consultant haematology · Patient guide
Multiplate platelet function analysis, whole-blood impedance aggregometry for antiplatelet response and bleeding risk.
Multiplate is a whole-blood impedance aggregometry test that measures platelet function in response to specific agonists (ADP, arachidonic acid, TRAP). Used to guide antiplatelet therapy (aspirin, clopidogrel), assess bleeding risk before surgery and diagnose platelet disorders.
Key facts
- 01
Definition
Whole-blood impedance aggregometry — platelet function measured directly in citrated blood.
- 02
Agonist-specific tests
ADP, ASPI (arachidonic acid) and TRAP assays isolate distinct platelet pathways.
- 03
Guides antiplatelet therapy
Confirms response to aspirin, clopidogrel, prasugrel or ticagrelor.
- 04
Pre-operative bleeding-risk assessment
Quantifies platelet function before cardiac and major surgery.
- 05
Reported in AU
Results expressed in arbitrary units (AU) against agonist-specific reference ranges.
- 06
Consultant haematology interpretation
Every report reviewed by a consultant haematologist against clinical context.
How the test works
From referral to report — what happens, in order.
A structured pathway from consultant referral to written interpretation — usually the same working day.
- 01
Haematology or cardiology referral
Referral from a consultant haematologist or cardiologist frames the clinical question.
- 02
Withhold new antiplatelets if requested
Only if the referring clinician has asked — never stop antiplatelets on your own.
- 03
Fresh blood sample (citrated)
A single venous sample into hirudin or citrate tubes, processed within hours.
- 04
Agonist-specific tests
ADP, ASPI and TRAP channels run in parallel on the Multiplate analyser.
- 05
Result within hours
Aggregation curves and AU values available the same working day.
- 06
Consultant interpretation
A consultant haematologist correlates numbers with drug regimen and bleeding history.
- 07
Structured plan
A written plan: continue, switch, withhold, transfuse or refer.
What it shows
When Multiplate is the right test.
Multiplate answers a specific question — is your platelet response to a drug adequate, and is your bleeding risk explained by platelet function.
-
Aspirin response (ASPI test)
Detects aspirin resistance via the arachidonic-acid pathway.
-
Clopidogrel response (ADP test)
Quantifies P2Y12 inhibition and identifies clopidogrel non-responders.
-
Ticagrelor response
Confirms adequate platelet inhibition on ticagrelor or prasugrel.
-
Baseline platelet function
A pre-treatment snapshot before starting antiplatelet therapy.
-
Von Willebrand disease screen
Supports work-up of suspected VWD alongside factor assays.
-
Congenital platelet disorder
Screens for inherited platelet function defects.
-
Post-cardiac surgery bleeding
Explains unexpected bleeding after CABG or valve surgery.
-
Red flag: high-on-treatment platelet reactivity — cardiology / interventional review
Elevated reactivity on antiplatelets after PCI warrants same-day cardiology review.
Treatment options
What a Multiplate result changes.
The result is only useful if it drives a decision. These are the options a consultant will typically weigh.
-
Continue current antiplatelet
Where the assay confirms adequate inhibition on the current regimen.
-
Switch antiplatelet (e.g. to ticagrelor)
For confirmed clopidogrel non-responders after PCI or stroke.
-
Add or withdraw an antiplatelet
Titrate dual therapy up or down based on assay and bleeding risk.
-
Delay surgery until washout
Postpone elective surgery until residual antiplatelet effect resolves.
-
Pre-op DDAVP for VWD
Desmopressin cover before surgery where VWD is confirmed.
-
Platelet transfusion for bleeding
Targeted transfusion where active bleeding is driven by platelet dysfunction.
-
Referral to specialist haematology
For congenital or complex acquired platelet disorders.
-
Structured follow-up
Repeat testing at intervals defined by the treating consultant.
Red flags
When to escalate — and not wait.
Multiplate is a planned investigation. These clinical situations need same-day specialist review, not a routine slot.
-
Non-responder to antiplatelet
Persistent high platelet reactivity despite standard dosing.
-
Post-PCI stent thrombosis risk
High on-treatment reactivity after coronary stenting.
-
Congenital platelet disorder
Lifelong bleeding history with abnormal aggregation.
-
Von Willebrand disease
Mucocutaneous bleeding and abnormal VWF workup.
-
Uraemic platelet dysfunction
Bleeding in advanced renal failure with abnormal aggregation.
-
Post-cardiac-surgery bleeding
Excessive chest-drain losses after cardiopulmonary bypass.
-
Antiphospholipid syndrome
Recurrent thrombosis with abnormal platelet profile.
-
Recent bleeding event
GI, intracranial or perioperative bleeding needing rapid stratification.
-
Warfarin + antiplatelet overlap
Combined anticoagulation and antiplatelet therapy raising bleeding risk.
Sources and standards
Guideline-backed, clinically reviewed.
This guide draws on the following authoritative sources. Reviewed by Pulse Atlas Editorial Board (); next review 2027-07-30.
- 01 Source
British Society for Haematology. Guidelines on platelet function testing.
British Society for Haematology. Guidelines on platelet function testing. - 02 Source
European Society of Cardiology. Guidelines on dual antiplatelet therapy.
European Society of Cardiology. Guidelines on dual antiplatelet therapy. - 03 Source
International Society on Thrombosis and Haemostasis. Platelet physiology guidance.
International Society on Thrombosis and Haemostasis. Platelet physiology guidance. - 04 Source
Roche Diagnostics. Multiplate analyser — technical documentation.
Roche Diagnostics. Multiplate analyser — technical documentation.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about Multiplate.
Quick answers on preparation, timing, AU values and how Multiplate compares with other platelet tests.
-
What does a Multiplate test show?
Multiplate measures how well your platelets clump together in response to specific agonists (ADP, arachidonic acid, TRAP). It shows whether antiplatelet drugs are working, whether platelet function is abnormal, and whether you have a raised bleeding risk before surgery.
-
Do I need to stop my antiplatelets before the test?
Only if your referring consultant has specifically asked you to. In most cases the test is done on treatment to check whether the drug is working — do not stop aspirin, clopidogrel, prasugrel or ticagrelor without explicit medical instruction.
-
How quickly are results available?
Multiplate is run on fresh citrated whole blood and the aggregation traces are generated within hours. A consultant haematology interpretation and written report typically follow the same working day.
-
What are AU values and what do they mean?
AU stands for arbitrary units — the standardised Multiplate output. Each agonist channel (ADP, ASPI, TRAP) has its own reference range, and the consultant interprets your AU values against the drugs you are taking and your clinical picture.
-
Is Multiplate the same as a bleeding time or PFA-100?
No. Multiplate uses whole-blood impedance aggregometry, which is more reproducible than bleeding time and complements — rather than replaces — PFA-100 or light transmission aggregometry.
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When should I seek urgent review?
Any active bleeding, chest pain after a recent stent, sudden neurological symptoms or unexplained bruising is an emergency — call 999 or attend A&E. Multiplate is a planned investigation, not an emergency test.
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In practice, in London
The London pathway for multiplate platelet function analysis
With multiplate platelet function analysis, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. Waiting lists on the NHS for multiplate platelet function analysis vary widely by borough and by how the GP letter reads. Privately in London, we can normally offer a slot inside the same week, sometimes within 48 hours if there’s a cancellation. The difference isn’t clinical quality — the consultants are frequently the same faces you’d see on the NHS — it’s the calendar.
In practice, a private multiplate platelet function analysis appointment in London means a named consultant, a proper hour in the room (or the equivalent on a video call), and a report you can actually read. Most of the imaging suites and endoscopy units we use sit within a mile of Harley Street or in Chelsea and Fulham, and turnaround on findings is measured in days, not weeks. For multiplate platelet function analysis specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
The value of going through a concierge for multiplate platelet function analysis isn’t access — anyone with an insurer or a credit card can get a private appointment in London. The value is knowing which consultant reads this particular presentation best, which unit turns reports around fastest, and which pathway won’t hit a dead end if the findings point somewhere unexpected.
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