Aspirin response evaluated by the VerifyNow Aspirin System and light transmission aggregometry.
BACKGROUND
Patients with inadequate platelet inhibition by aspirin, referred to as aspirin resistance, might have an increased risk of suffering cardiovascular events. Therefore, identification of these patients by measuring platelet function is of great interest. Our objectives were to evaluate performance parameters of VerifyNow and to determine the agreement between VerifyNow and light transmission aggregometry (LTA) ad modum Born.


METHODS
We included 21 healthy volunteers and 40 patients with stable coronary artery disease. Duplicate measurements of platelet aggregation were performed using VerifyNow and LTA (arachidonic acid 1.0 mM) in healthy volunteers before aspirin and in all participants on four consecutive days during treatment with non-enteric-coated aspirin 75 mg daily. VerifyNow test results were expressed in Aspirin Reaction Units (ARU) and LTA test results in percent of maximal aggregation. The cut-off for determination of aspirin resistance was > or =550 ARU and > or =20%, respectively.


RESULTS
All participants were compliant, confirmed by complete suppression of serum-thromboxane B(2). VerifyNow was highly repeatable with a coefficient of variance of 0.5% at baseline and 3.0% during aspirin treatment. No individuals were identified as aspirin resistant with VerifyNow, whereas seven (12%) individuals were identified with LTA. ROC analysis using LTA as the gold standard showed poor sensitivity and good specificity with a cut-off at 550 ARU.


CONCLUSIONS
VerifyNow was highly repeatable, but further studies are needed to investigate the relevance of the cut-off level at 550 ARU for detecting aspirin resistance.
Nielsen
Helle L
HL
Department of Cardiology, Aarhus University Hospital Skejby, Denmark.
Kristensen
Steen D
SD
Thygesen
Sofie S
SS
Mortensen
Jette
J
Pedersen
Susanne B
SB
Grove
Erik L
EL
Hvas
Anne-Mette
AM
D000328:Adult; D001241:Aspirin / Q000494:pharmacology*; D001792:Blood Platelets / Q000187:drug effects* / Q000502:physiology; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000097:blood / Q000188:drug therapy*; D004351:Drug Resistance; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010349:Patient Compliance; D010974:Platelet Aggregation / Q000187:drug effects / Q000502:physiology; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology*; D010976:Platelet Count; D010979:Platelet Function Tests / Q000379:methods; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013928:Thromboxane A2 / Q000378:metabolism
D006454:Hemoglobins; D010975:Platelet Aggregation Inhibitors; D013928:Thromboxane A2; D001241:Aspirin