Different methodologies for evaluating the effect of clopidogrel on platelet function in high-risk coronary artery disease patients

Rita Paniccia, E. Antonucci, A. M. Gori, R. Marcucci, C. Giglioli, D. Antoniucci, G. F. Gensini, R. Abbate, D. Prisco

Research output: Contribution to journalArticle

Abstract

Background: Two point-of-care (POC) systems have been recently proposed as rapid tools with which to evaluate residual platelet reactivity (RPR) in coronary artery disease (CAD) patients. Objectives and Methods: We compared Platelet Function Analyzer-100 (PFA-100) closure times (CTs) by collagen/adenosine 5́-diphosphate (ADP) (C/ADP CT) cartridge and the VerifyNow P2Y12 Assay (VerifyNow) with light transmission aggregation (LTA) induced by 2 and 10 μmol L-1 ADP in 1267 CAD patients on dual antiplatelet therapy who underwent percutaneous coronary intervention. We also performed the vasodilator-stimulated phosphoprotein (VASP) phosphorylation assay by cytofluorimetric analysis in a subgroup of 115 patients. Results: Cut-off values for identifying RPR were: ≥ 54% and ≥ 66% for LTA induced by 2 and 10 μmol L-1 ADP respectively, and ≥ 264 P2Y12 Reaction Units (PRU) for VerifyNow. The cut-off for PFA-100 C/ADP CT was ≥ 68 s. RPR was detected in 25.1% of patients by 2 μmol L -1 ADP-induced LTA (ADP-LTA), in 23.2% by 10 μmol L -1 ADP-LTA, in 24.4% by PFA-100, and in 24.7% by VerifyNow. PFA-100 results did not parallel those obtained with LTA. VerifyNow showed a significant correlation (Ρ = 0.62, P <0.001) and significant agreement (k = 0.34, P <0.001) with LTA induced by 2 μmol L -1 ADP. The correlation was similar but the agreement was better between VerifyNow and 10 μmol L -1 ADP-LTA (Ρ = 0.64, P <0.0001; k = 0.43, P <0.001). Significant relationships were found between VASP platelet reactivity index and both ADP-LTA and VerifyNow. PFA-100 C/ADP CT did not significantly correlate with any of the other assays. Conclusions: Our results show a significant correlation betweenLTA and VerifyNow but not the PFA-100 C/ADP assay. Clinical validation studies for POC systems are necessary.

Original languageEnglish
Pages (from-to)1839-1847
Number of pages9
JournalJournal of Thrombosis and Haemostasis
Volume5
Issue number9
DOIs
Publication statusPublished - Sep 2007

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clopidogrel
Adenosine Diphosphate
Coronary Artery Disease
Blood Platelets
Light
Point-of-Care Systems

Keywords

  • Antiplatelet treatment
  • Platelet
  • Platelet function
  • Point-of-care testing

ASJC Scopus subject areas

  • Medicine(all)

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Different methodologies for evaluating the effect of clopidogrel on platelet function in high-risk coronary artery disease patients. / Paniccia, Rita; Antonucci, E.; Gori, A. M.; Marcucci, R.; Giglioli, C.; Antoniucci, D.; Gensini, G. F.; Abbate, R.; Prisco, D.

In: Journal of Thrombosis and Haemostasis, Vol. 5, No. 9, 09.2007, p. 1839-1847.

Research output: Contribution to journalArticle

Paniccia, R, Antonucci, E, Gori, AM, Marcucci, R, Giglioli, C, Antoniucci, D, Gensini, GF, Abbate, R & Prisco, D 2007, 'Different methodologies for evaluating the effect of clopidogrel on platelet function in high-risk coronary artery disease patients', Journal of Thrombosis and Haemostasis, vol. 5, no. 9, pp. 1839-1847. https://doi.org/10.1111/j.1538-7836.2007.02656.x
Paniccia, Rita ; Antonucci, E. ; Gori, A. M. ; Marcucci, R. ; Giglioli, C. ; Antoniucci, D. ; Gensini, G. F. ; Abbate, R. ; Prisco, D. / Different methodologies for evaluating the effect of clopidogrel on platelet function in high-risk coronary artery disease patients. In: Journal of Thrombosis and Haemostasis. 2007 ; Vol. 5, No. 9. pp. 1839-1847.
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abstract = "Background: Two point-of-care (POC) systems have been recently proposed as rapid tools with which to evaluate residual platelet reactivity (RPR) in coronary artery disease (CAD) patients. Objectives and Methods: We compared Platelet Function Analyzer-100 (PFA-100) closure times (CTs) by collagen/adenosine 5́-diphosphate (ADP) (C/ADP CT) cartridge and the VerifyNow P2Y12 Assay (VerifyNow) with light transmission aggregation (LTA) induced by 2 and 10 μmol L-1 ADP in 1267 CAD patients on dual antiplatelet therapy who underwent percutaneous coronary intervention. We also performed the vasodilator-stimulated phosphoprotein (VASP) phosphorylation assay by cytofluorimetric analysis in a subgroup of 115 patients. Results: Cut-off values for identifying RPR were: ≥ 54{\%} and ≥ 66{\%} for LTA induced by 2 and 10 μmol L-1 ADP respectively, and ≥ 264 P2Y12 Reaction Units (PRU) for VerifyNow. The cut-off for PFA-100 C/ADP CT was ≥ 68 s. RPR was detected in 25.1{\%} of patients by 2 μmol L -1 ADP-induced LTA (ADP-LTA), in 23.2{\%} by 10 μmol L -1 ADP-LTA, in 24.4{\%} by PFA-100, and in 24.7{\%} by VerifyNow. PFA-100 results did not parallel those obtained with LTA. VerifyNow showed a significant correlation (Ρ = 0.62, P <0.001) and significant agreement (k = 0.34, P <0.001) with LTA induced by 2 μmol L -1 ADP. The correlation was similar but the agreement was better between VerifyNow and 10 μmol L -1 ADP-LTA (Ρ = 0.64, P <0.0001; k = 0.43, P <0.001). Significant relationships were found between VASP platelet reactivity index and both ADP-LTA and VerifyNow. PFA-100 C/ADP CT did not significantly correlate with any of the other assays. Conclusions: Our results show a significant correlation betweenLTA and VerifyNow but not the PFA-100 C/ADP assay. Clinical validation studies for POC systems are necessary.",
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T1 - Different methodologies for evaluating the effect of clopidogrel on platelet function in high-risk coronary artery disease patients

AU - Paniccia, Rita

AU - Antonucci, E.

AU - Gori, A. M.

AU - Marcucci, R.

AU - Giglioli, C.

AU - Antoniucci, D.

AU - Gensini, G. F.

AU - Abbate, R.

AU - Prisco, D.

PY - 2007/9

Y1 - 2007/9

N2 - Background: Two point-of-care (POC) systems have been recently proposed as rapid tools with which to evaluate residual platelet reactivity (RPR) in coronary artery disease (CAD) patients. Objectives and Methods: We compared Platelet Function Analyzer-100 (PFA-100) closure times (CTs) by collagen/adenosine 5́-diphosphate (ADP) (C/ADP CT) cartridge and the VerifyNow P2Y12 Assay (VerifyNow) with light transmission aggregation (LTA) induced by 2 and 10 μmol L-1 ADP in 1267 CAD patients on dual antiplatelet therapy who underwent percutaneous coronary intervention. We also performed the vasodilator-stimulated phosphoprotein (VASP) phosphorylation assay by cytofluorimetric analysis in a subgroup of 115 patients. Results: Cut-off values for identifying RPR were: ≥ 54% and ≥ 66% for LTA induced by 2 and 10 μmol L-1 ADP respectively, and ≥ 264 P2Y12 Reaction Units (PRU) for VerifyNow. The cut-off for PFA-100 C/ADP CT was ≥ 68 s. RPR was detected in 25.1% of patients by 2 μmol L -1 ADP-induced LTA (ADP-LTA), in 23.2% by 10 μmol L -1 ADP-LTA, in 24.4% by PFA-100, and in 24.7% by VerifyNow. PFA-100 results did not parallel those obtained with LTA. VerifyNow showed a significant correlation (Ρ = 0.62, P <0.001) and significant agreement (k = 0.34, P <0.001) with LTA induced by 2 μmol L -1 ADP. The correlation was similar but the agreement was better between VerifyNow and 10 μmol L -1 ADP-LTA (Ρ = 0.64, P <0.0001; k = 0.43, P <0.001). Significant relationships were found between VASP platelet reactivity index and both ADP-LTA and VerifyNow. PFA-100 C/ADP CT did not significantly correlate with any of the other assays. Conclusions: Our results show a significant correlation betweenLTA and VerifyNow but not the PFA-100 C/ADP assay. Clinical validation studies for POC systems are necessary.

AB - Background: Two point-of-care (POC) systems have been recently proposed as rapid tools with which to evaluate residual platelet reactivity (RPR) in coronary artery disease (CAD) patients. Objectives and Methods: We compared Platelet Function Analyzer-100 (PFA-100) closure times (CTs) by collagen/adenosine 5́-diphosphate (ADP) (C/ADP CT) cartridge and the VerifyNow P2Y12 Assay (VerifyNow) with light transmission aggregation (LTA) induced by 2 and 10 μmol L-1 ADP in 1267 CAD patients on dual antiplatelet therapy who underwent percutaneous coronary intervention. We also performed the vasodilator-stimulated phosphoprotein (VASP) phosphorylation assay by cytofluorimetric analysis in a subgroup of 115 patients. Results: Cut-off values for identifying RPR were: ≥ 54% and ≥ 66% for LTA induced by 2 and 10 μmol L-1 ADP respectively, and ≥ 264 P2Y12 Reaction Units (PRU) for VerifyNow. The cut-off for PFA-100 C/ADP CT was ≥ 68 s. RPR was detected in 25.1% of patients by 2 μmol L -1 ADP-induced LTA (ADP-LTA), in 23.2% by 10 μmol L -1 ADP-LTA, in 24.4% by PFA-100, and in 24.7% by VerifyNow. PFA-100 results did not parallel those obtained with LTA. VerifyNow showed a significant correlation (Ρ = 0.62, P <0.001) and significant agreement (k = 0.34, P <0.001) with LTA induced by 2 μmol L -1 ADP. The correlation was similar but the agreement was better between VerifyNow and 10 μmol L -1 ADP-LTA (Ρ = 0.64, P <0.0001; k = 0.43, P <0.001). Significant relationships were found between VASP platelet reactivity index and both ADP-LTA and VerifyNow. PFA-100 C/ADP CT did not significantly correlate with any of the other assays. Conclusions: Our results show a significant correlation betweenLTA and VerifyNow but not the PFA-100 C/ADP assay. Clinical validation studies for POC systems are necessary.

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KW - Platelet

KW - Platelet function

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