Impact of timing from blood sampling to pharmacodynamic assessment on measures of platelet reactivity in patients treated with P2Y12 receptor inhibitors

Fabiana Rollini; Francesco Franchi; Kamaldeep Singh; Jung Rae Cho; Mona Bhatti; Christopher DeGroat; Jenny Hu; Niti Aggarwal; Zeina Alobaidi; Estela Thano; Elisabetta Ferrante; Martin M. Zenni; Theodore A. Bass; Dominick J. Angiolillo

doi:10.1160/TH16-05-0377

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2016; 116(06): 1060-1069
DOI: 10.1160/TH16-05-0377

Cellular Haemostasis and Platelets

Schattauer Publishers Schattauer

Impact of timing from blood sampling to pharmacodynamic assessment on measures of platelet reactivity in patients treated with P2Y₁₂ receptor inhibitors

Fabiana Rollini

¹University of Florida College of Medicine – Jacksonville, Jacksonville, Florida, USA

,

Francesco Franchi

¹University of Florida College of Medicine – Jacksonville, Jacksonville, Florida, USA

,

Kamaldeep Singh

¹University of Florida College of Medicine – Jacksonville, Jacksonville, Florida, USA

,

Jung Rae Cho

¹University of Florida College of Medicine – Jacksonville, Jacksonville, Florida, USA

,

Mona Bhatti

¹University of Florida College of Medicine – Jacksonville, Jacksonville, Florida, USA

,

Christopher DeGroat

¹University of Florida College of Medicine – Jacksonville, Jacksonville, Florida, USA

,

Jenny Hu

¹University of Florida College of Medicine – Jacksonville, Jacksonville, Florida, USA

,

Niti Aggarwal

¹University of Florida College of Medicine – Jacksonville, Jacksonville, Florida, USA

,

Zeina Alobaidi

¹University of Florida College of Medicine – Jacksonville, Jacksonville, Florida, USA

,

Estela Thano

¹University of Florida College of Medicine – Jacksonville, Jacksonville, Florida, USA

,

Elisabetta Ferrante

¹University of Florida College of Medicine – Jacksonville, Jacksonville, Florida, USA

,

Martin M. Zenni

¹University of Florida College of Medicine – Jacksonville, Jacksonville, Florida, USA

,

Theodore A. Bass

¹University of Florida College of Medicine – Jacksonville, Jacksonville, Florida, USA

,

Dominick J. Angiolillo

¹University of Florida College of Medicine – Jacksonville, Jacksonville, Florida, USA

› Author Affiliations

Abstract

Summary

Several platelet function tests (PFT) are available to assess the pharmacodynamic (PD) effects of P2Y₁₂ inhibitors. However, there are technical variances between PFT, and P2Y₁₂ inhibitors differ in pharmacological properties. Manufactures of PFT recommend a time-frame within which assessments needs to be executed. However, if the timing from blood sampling to processing affects PD results is unknown. We conducted a prospective study assessing the impact of timing from blood sampling to processing on PD measures using three different PFT. We studied 60 aspirin-treated patients with coronary artery disease (CAD) on maintenance P2Y₁₂ inhibiting therapy [clopidogrel 75 mg/day (n=20), prasugrel 10 mg/day (n=20) and ticagrelor 90 mg bid (n=20)]. PD assessments (trough levels) were performed by VerifyNow P2Y12 (VN), light transmittance aggregometry (LTA) and vasodilator-stimulated phosphoprotein (VASP) at 30 minutes, 2 and 4 hours post-sampling; VASP was also performed at 24 hours. P2Y₁₂ reaction units (PRU) by VN significantly decreased over time with all P2Y₁₂ inhibitors (clopidogrel p<0.001; prasugrel p=0.016; ticagrelor p<0.001). PRU at 30 minutes and 2 hours were similar, but decreased at 4 hours. LTA showed consistent findings with VN. Conversely, PD measures as assessed by VASP were stable over time (p>0.1 for all P2Y₁₂ inhibitors). In conclusion, in CAD patients on maintenance therapy with P2Y₁₂ inhibitors, timing from blood sampling to processing significantly influences PD measures as assessed by VN and LTA, but not by VASP.

Clopidogrel - prasugrel - ticagrelor - sample collection and sample processing

Full Text

References

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