Comparison of two methods to assess variability of platelet response to anti-platelet therapies in patients with acute coronary syndrome undergoing angioplasty

Charaf E. Ahnadi; Faiza F. Boughrassa; E. Sabrinah Chapman-Montgomery; Véronique Poisson; André Gervais; David Okrongly; Andrew M. Grant

doi:10.1160/TH04-02-0078

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2004; 92(06): 1207-1213
DOI: 10.1160/TH04-02-0078

Theme Issue Article

Schattauer GmbH

Comparison of two methods to assess variability of platelet response to anti-platelet therapies in patients with acute coronary syndrome undergoing angioplasty

Charaf E. Ahnadi

¹Collaborative Research for Effective Diagnostics, Québec, Canada

,

Faiza F. Boughrassa

¹Collaborative Research for Effective Diagnostics, Québec, Canada

,

E. Sabrinah Chapman-Montgomery

³Laboratory Testing Segment Hematology R & D, Bayer Diagnostics, Tarrytown, New York, USA

,

Véronique Poisson

¹Collaborative Research for Effective Diagnostics, Québec, Canada

,

André Gervais

²Cardiology Dept., Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada

,

David Okrongly

³Laboratory Testing Segment Hematology R & D, Bayer Diagnostics, Tarrytown, New York, USA

,

Andrew M. Grant

¹Collaborative Research for Effective Diagnostics, Québec, Canada

› Author Affiliations

Abstract

Summary

The study investigated the clinical usefulness of a new method to evaluate platelet activation and the variability of platelet response to anti-platelet therapy in patients undergoing percutaneous transluminal coronary angioplasty (PTCA). Platelet activation was assessed in parallel by a new method for platelet density measurements (MPC, Mean Platelet Component Concentration), on the automated ADVIA 120 Hematology System and by the classic measurement of P-selectin (CD62P) expression, on a fluorescence flow cytometer. Patients received a loading dose of clopidogrel (300 mg; n = 29) or a bolus of abciximab (0.25 mg/kg; n = 15). Blood samples were collected before (baseline) and at different times after PTCA and antiplatelet drugs administration. Our data showed a close inverse correlation between the change in MPC and the CD62P fluorescence surface marker expression (r = 0.776, P<0.0001). Individual platelet activation determinations in patients receiving either clopidogrel or abciximab showed a variation in platelet activation as assayed by MPC and CD62P expression. Patients were characterized as having either high platelet activity upon admission and positive response to treatment or no detectable platelet activation before or after treatment. This study demonstrates the heterogeneity of platelet activation states in ACS patients undergoing coronary angioplasty. The present work also illustrates the potential use of the MPC parameter, generated on an automated hematology system, to define high risk patients and to monitor the variability of platelet response to anti-platelet therapies.

Keywords

Platelets activation - anti-platelet drugs - ADVIA 120 - CD62P

Full Text

References

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