45 Reduced thrombin generation and/or decreased platelet response in women with HMB Figure 2: Platelet stimulation with TRAP (A), CRP (B) and ADP (C) was measured with expression of P-selectin (X-axis) on the membrane and the activation of αΙΙbβ3 (Y-axis). The white area represents the reference range of 123 healthy employees of the UMC Utrecht, and the values of patients with HMB are plotted in the graphs. All patients that fall outside the reference area into the grey area for reduced platelet response were classified as platelet function disorder. A total of 14 patients of the 58 (24%) were defined with a platelet function defect. For each agonist, we quantified both P-selectin expression and αIIbβ3 activation. If at least one of the platelet activation parameters after stimulation with at least one of the agonists fell outside the reference ranges of the healthy reference group as defined in Table 1, then those patients were defined as having a platelet function defect (PFD). Using this criterion, we classified 14 (24%) patients with a PFD. In the same blood samples, we tested the response 3
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