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Comparison of methods to evaluate clopidogrel-mediated platelet inhibition after percutaneous intervention with stent implantation
- Source :
- Thrombosis and Haemostasis. 101:333-339
- Publication Year :
- 2009
- Publisher :
- Georg Thieme Verlag KG, 2009.
-
Abstract
- SummaryA high on-treatment residual ADP-inducible platelet reactivity in light transmission aggregometry (LTA) has been associated with an increased risk of adverse outcomes after percutaneous coronary intervention (PCI). However, LTA is weakly standardized, and results obtained in one laboratory may not be comparable to those obtained in another one. We therefore sought to determine the test correlating best with LTA to estimate clopidogrel-mediated platelet inhibition in 80 patients on dual antiplatelet therapy after elective percutaneous intervention with stent implantation. We selected the VerifyNow P2Y12 assay, the vasodilator-stimulated phosphoprotein phosphorylation assay, multiple electrode platelet aggregometry and the Impact-R for comparisons with LTA. Cut-off values for residual ADP-inducible platelet reactivity were defined according to quartiles of each assay. Sensitivities and specificities of the different platelet function tests were based on the results from LTA. The results from all four assays correlated significantly with those from LTA. The VerifyNow P2Y12 assay revealed the strongest correlation (r = 0.61, p < 0.001). Sensitivities and specificities ranged from 35% to 55%, and from 78.3% to 85%, respectively. In conclusion, although all assays correlated significantly with LTA, they need to be improved to become clinically used diagnostic tests. Further, it may be too early to define the gold standard method for assessing residual ADP-inducible platelet reactivity and generally acceptable cut-off values.
- Subjects :
- Adult
Male
medicine.medical_specialty
Ticlopidine
Percutaneous
Platelet Aggregation
Platelet Function Tests
medicine.medical_treatment
Drug Resistance
Urology
Sensitivity and Specificity
Article
P2Y12
Predictive Value of Tests
Purinergic P2 Receptor Antagonists
Humans
Medicine
Platelet
Angioplasty, Balloon, Coronary
Phosphorylation
Aged
Aged, 80 and over
Aspirin
Receptors, Purinergic P2
business.industry
Microfilament Proteins
Reproducibility of Results
Percutaneous coronary intervention
Hematology
Gold standard (test)
Middle Aged
Phosphoproteins
Platelet Activation
Clopidogrel
Receptors, Purinergic P2Y12
Adenosine Diphosphate
Cardiovascular Diseases
Conventional PCI
Immunology
Drug Therapy, Combination
Female
Stents
business
Cell Adhesion Molecules
Platelet Aggregation Inhibitors
medicine.drug
Subjects
Details
- ISSN :
- 2567689X and 03406245
- Volume :
- 101
- Database :
- OpenAIRE
- Journal :
- Thrombosis and Haemostasis
- Accession number :
- edsair.doi.dedup.....2912d52ad352a2e0105bd5829342454e
- Full Text :
- https://doi.org/10.1160/th08-09-0577