Comparison of different methods to evaluate the effect of aspirin on platelet function in high-risk patients with ischemic heart disease receiving dual antiplatelet treatment.
Patients with coronary artery disease (CAD) receiving aspirin therapy with a residual platelet reactivity (RPR) may be at increased risk of ischemic vascular events. Point-of-care (POC) methods PFA-100 (Dade-Behring, Marburg, Germany) and VerifyNow (Accumetrics, San Diego, CA) assays have been suggested as rapid tools to evaluate RPR. We compared PFA-100 closure times by collagen/epinephrine and VerifyNow Aspirin assays with light transmission aggregation (LTA) induced by 1 mmol/L of arachidonic acid in 484 patients with CAD undergoing percutaneous coronary intervention and receiving dual antiplatelet therapy. RPR was detected in 30.0% of patients by LTA, in 32.4% by PFA-100, and in 14.3% by VerifyNow. Significant correlations were found among 3 methods (all P < .0001). In relation to the presence or absence of RPR by LTA and PFA-100, by LTA and VerifyNow, and by PFA-100 and VerifyNow, samples were significantly concordant (all P < .0001). Assuming LTA as the reference method, PFA-100 and VerifyNow showed sensitivity of 62.1% and 39.3% and specificity of 80.2% and 96.4%, respectively. The cutoff values for POC methods need to be defined for clinical use.
Paniccia
Rita
R
Department of Medical and Surgical Critical Care, Thrombosis Center, Center for Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Italy.
Antonucci
Emilia
E
Gori
Anna Maria
AM
Marcucci
Rossella
R
Poli
Serena
S
Romano
Eloisa
E
Valente
Serafina
S
Giglioli
Cristina
C
Fedi
Sandra
S
Gensini
Gian Franco
GF
Abbate
Rosanna
R
Prisco
Domenico
D
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D016718:Arachidonic Acid / Q000494:pharmacology; D001241:Aspirin / Q000494:pharmacology*; D001792:Blood Platelets / Q000187:drug effects* / Q000502:physiology; D000077144:Clopidogrel; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000188:drug therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D010979:Platelet Function Tests / Q000379:methods*; D019095:Point-of-Care Systems; D012680:Sensitivity and Specificity; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use
D010975:Platelet Aggregation Inhibitors; D016718:Arachidonic Acid; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin