Naslov
Comparison of P2Y12-receptor blockade in cardiovascular disease patients undergoing antiplatelet therapy by Innovance PFA P2Y assay and light transmission aggregometry using ADP agonist.

Autori
Margetić Sandra ; Getaldić Biserka ; Vuga Ivana, Vrkić Nada

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
XXIV Congress of the International Society on Thrombosis and Haemostasis

Mjesto i datum
Amsterdam, Nizozemska, 29.06.2013. - 04.07.2013

Vrsta sudjelovanja
Poster

Vrsta recenzije
Nije recenziran

Ključne riječi
antiplatelet therapy; Platelet Function Analyzer; Innovance PFA P2Y assay; monitoring clopidogrel therapy

Sažetak
Background: In the recent years platelet function testing has expanded to include the assessment of the effectiveness of antiplatelet therapy in both research and clinical settings. Light transimission aggregometry (LTA) is still regarded as the gold standard for platelet function testing, despite its technical limitations. Development of point-of-care platelet function analyzers, such as Platelet Function Analyzer (PFA-100 system, Siemens, Germany) has allowed simpler and rapid assessment of platelet function using whole blood sample and thus presenting the potential for widespread clinical use. The recently available P2Y cartridge (Innovance PFA P2Y) of the PFA-100 system is specifically designed for monitoring clopidogrel therapy by measuring ADP-induced platelet aggregation. Aim: The aim of this study was to evaluate the PFA-100 P2Y assay by measuring on-treatment platelet reactivity in parallel by LTA method using ADP agonist. We aimed to establish the agreement between results assessed by the two methods. Methods: Twenty (7 females, 13 males) stable cardiovascular patients under antiplatelet therapy were included in the study. 15 patients were treated with clopidogrel alone (75 mg/day) and the remaining 5 patients were on acetylsalicylic acid (ASA, aspirin, 100 mg/day) alone. Clopidogrel-induced inhibition of platelet aggregation was assessed by PFA-100 P2Y assay and by LTA method using ADP agonist on Behring Coagulation Timer (Siemens, Germany). The PFA-100 P2Y is an assay in which citrated whole blood is aspirated through disposable cartridge containing ADP thus measuring the antiplatelet effect of clopidogrel due to P2Y12-receptor blockade. Platelet aggregation is determined by the time taken for the occlusion of blood flow. The cut- off value for PFA P2Y was defined at 106 seconds according to the manufacturers recommendations and cut-off for LTA using 20 µmol/L ADP was defined as value <60% according to the literature data. Results: The clopidogrel treatment target value for PFA P2Y (>106s) was achieved in all 15 patients on clopidogrel therapy, while ADP- induced LTA found 14 of 15 patients on clopidogrel to be responsive (<60%). Using cut- off values of 60% (LTA) and 106s (PFA P2Y), the aggrement between the two methods was 19/20 (0.95), while 1 of 20 (0.05) results showed discrepancy. The only discordant result showed reduced platelet aggregation by P2Y (>300s) and LTA ADP-induced aggregation of 64%. All five patients on ASA therapy alone had P2Y values below 106s. Conclusions: Comparison of the results obtained by the two methods has shown very good agreement. Sensitivity of PFA P2Y assay in detecting responsiveness to clopidogrel was comparable to LTA method using ADP agonist. The results suggest PFA P2Y assay to be suitable for detection of P2Y12-receptor blockade and monitoring the antiplatelet effect of clopidogrel. Cut-off value (>106s) given by manufacturer can be considered as suitable for the defining the responsiveness to clopidogrel. The results in patients on ASA therapy alone showed that this therapy has no effect on the PFA P2Y assay. Compared with the LTA method, PFA P2Y assay is much easier to perform, requires smaller amount of whole blood sample and results are accessible in a shorter period of time.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA