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Thromb Haemost 2009; 101(02): 333-339
DOI: 10.1160/TH08-09-0577
Platelets and Blood Cells
Schattauer GmbH

Comparison of methods to evaluate clopidogrel-mediated platelet inhibition after percutaneous intervention with stent implantation

Thomas Gremmel
1   Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
,
Sabine Steiner
1   Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
,
Daniela Seidinger
1   Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
,
Renate Koppensteiner
1   Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
,
Simon Panzer   *
2   Clinical Department for Blood Group Serology, Medical University of Vienna, Vienna, Austria
,
Christoph W. Kopp   *
1   Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
› Author Affiliations
Further Information

Publication History

Received: 05 September 2008

Accepted after minor revision: 31 January 2008

Publication Date:
23 November 2017 (online)

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Summary

A 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.

Keywords

Antiplatelet agents - platelet aggregation - platelet function tests

* These authors contributed equally to this study.


 

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