Comparing of light transmittance aggregometry and modified thrombelastograph in predicting clinical outcomes in Chinese patients undergoing coronary stenting with clopidogrel.

Xiao-fang Tang; Ya-ling Han; Jia-hui Zhang; Jing Wang; Yin Zhang; Bo XU; Zhan Gao; Shu-bin Qiao; Jue Chen; Yuan WU; Ji-lin Chen; Run-lin Gao; Yue-jin Yang; Jin-qing Yuan

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Comparing of light transmittance aggregometry and modified thrombelastograph in predicting clinical outcomes in Chinese patients undergoing coronary stenting with clopidogrel.

Author: Xiao-Fang TANG ; Ya-Ling HAN ; Jia-Hui ZHANG ; Jing WANG ; Yin ZHANG ; Bo XU ; Zhan GAO ; Shu-Bin QIAO ; Jue CHEN ; Yuan WU ; Ji-Lin CHEN ; Run-Lin GAO ; Yue-Jin YANG ; Jin-Qing YUAN ¹
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1. Department of Cardiology, Centre for Coronary Heart Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Publication Type:Journal Article
MeSH: Aged; Asian Continental Ancestry Group; Female; Humans; Linear Models; Male; Middle Aged; Percutaneous Coronary Intervention; methods; Platelet Aggregation; drug effects; Platelet Aggregation Inhibitors; therapeutic use; Prospective Studies; Ticlopidine; analogs & derivatives; therapeutic use
From: Chinese Medical Journal 2015;128(6):774-779
CountryChina
Language:English
Abstract:
BACKGROUNDSeveral platelet function tests are currently used to measure responsiveness to antiplatelet therapy. This study was to compare two tests, light transmittance aggregometry (LTA) and modified thrombelastography (mTEG), for predicting clinical outcomes in Chinese patients after percutaneous coronary intervention (PCI).
METHODSProspective, observational, single-center study of 789 Chinese patients undergoing PCI was enrolled. This study was investigated the correlations between the two tests and performed receiver operating characteristic curve (ROC) analysis for major adverse cardiovascular events (MACEs) at 1-year follow-up.
RESULTSMACEs occurred in 32 patients (4.1%). Correlations were well between the two tests in the adenosine diphosphate induced platelet reactivity (Spearman r = 0.733, P < 0.001). ROC-curve analysis demonstrated that LTA (area under the curve [AUC]: 0.677; 95% confidence interval [CI]: 0.643-0.710; P = 0.0009), and mTEG (AUC: 0.684; 95% CI: 0.650-0.716; P = 0.0001) had moderate ability to discriminate between patients with and without MACE. MACE occurred more frequently in patients with high on-treatment platelet reactivity (HPR) when assessed by LTA (7.4% vs. 2.7%; P < 0.001), and by TEG (6.7% vs. 2.6%; P < 0.001). Kaplan-Meier analysis demonstrated that HPR based on the LTA and mTEG was associated with almost 3-fold increased risk of MACE at 1-year follow-up.
CONCLUSIONSThe correlation between LTA and mTEG is relatively high in Chinese patients. HPR measured by LTA and mTEG were significantly associated with MACE in Chinese patients undergoing PCI.