Head to Head Comparison of Two Point-of-care Platelet Function Tests Used for Assessment of On-clopidogrel Platelet Reactivity in Chinese Acute Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention.
- Author:
Yi YAO
1
;
Jia-Hui ZHANG
1
;
Xiao-Fang TANG
1
;
Chen HE
1
;
Yuan-Liang MA
1
;
Jing-Jing XU
1
;
Ying SONG
1
;
Ru LIU
1
;
Xian-Min MENG
2
;
Lei SONG
1
;
Miao WANG
2
;
Run-Lin GAO
1
;
Jin-Qing YUAN
1
Author Information
- Publication Type:Journal Article
- MeSH: Adenosine Diphosphate; therapeutic use; Aged; Aspirin; therapeutic use; Blood Platelets; drug effects; China; Female; Humans; Male; Middle Aged; Myocardial Infarction; drug therapy; surgery; Percutaneous Coronary Intervention; methods; Platelet Aggregation; drug effects; Platelet Aggregation Inhibitors; therapeutic use; Point-of-Care Systems; Receptors, Purinergic P2Y12; metabolism; Thrombelastography; Ticlopidine; analogs & derivatives; therapeutic use
- From: Chinese Medical Journal 2016;129(19):2269-2274
- CountryChina
- Language:English
-
Abstract:
BACKGROUNDPlatelet function tests are widely used in clinical practice to guide personalized antiplatelet therapy. In China, the thromboelastography (TEG) test has been well accepted in clinics, whereas VerifyNow, mainly used for scientific research, has not been used in routine clinical practice. The aim of the current study was to compare these two point-of-care platelet function tests and to analyze the consistency between the two tests for evaluating on-clopidogrel platelet reactivity in Chinese acute myocardial infarction patients undergoing percutaneous coronary intervention (PCI).
METHODSA total of 184 patients admitted to Fuwai Hospital between August 2014 and May 2015 were enrolled in the study. On-clopidogrel platelet reactivity was assessed 3 days after PCI by TEG and VerifyNow using adenosine diphosphate as an agonist. Based on the previous reports, an inhibition of platelet aggregation (IPA) <30% for TEG or a P2Y12 reaction unit (PRU) >230 for VerifyNow was defined as high on-clopidogrel platelet reactivity (HPR). An IPA >70% or a PRU <178 was defined as low on-clopidogrel platelet reactivity (LPR). Correlation and agreement between the two methods were analyzed using the Spearman correlation coefficient (r) and kappa value (κ), respectively.
RESULTSOur results showed that VerifyNow and TEG had a moderate but significant correlation in evaluating platelet reactivity (r = -0.511). A significant although poor agreement (κ = 0.225) in identifying HPR and a significantly moderate agreement in identifying LPR (κ = 0.412) were observed between TEG and VerifyNow. By using TEG as the reference for comparison, the cutoff values of VerifyNow for the Chinese patients in this study were identified as PRU >205 for HPR and PRU <169 for LPR.
CONCLUSIONSBy comparing VerifyNow to TEG which has been widely used in clinics, VerifyNow could be an attractive alternative to TEG for monitoring on-clopidogrel platelet reactivity in Chinese patients.
