title: Usefulness of the INNOVANCE PFA P2Y test cartridge for the detection of patients with congenital defects of the platelet P2Y₁₂ receptor for adenosine diphosphate.
abstract: BACKGROUND
  The platelet function analyzer (PFA)-100 is used in clinical practice to screen patients with bleeding diathesis and suspected defects of primary hemostasis. A new cartridge, INNOVANCE PFA P2Y, has been specifically developed to monitor patients' response to drugs inhibiting the platelet P2Y₁₂ receptor for ADP. In this study, we compared the ability of INNOVANCE PFA P2Y to detect congenital defects of the platelet P2Y₁₂ receptor to that of standard cartridge formulations currently in clinical use.
  
  
  METHODS
  We studied two patients with severe P2Y₁₂ deficiency, one patient with heterozygous P2Y₁₂ deficiency and one with dysfunctional P2Y₁₂ receptor. Closure times were measured using 3 cartridges: collagen/ADP, collagen/epinephrine, and INNOVANCE PFA P2Y. The results obtained in the four patients with P2Y₁₂ defects were compared to those obtained for 20 healthy controls.
  
  
  RESULTS
  In 2 patients with severe P2Y₁₂ deficiency, closure times of INNOVANCE PFA P2Y and collagen/ADP cartridges were >300 s, while those of collagen/epinephrine cartridge were variable (186s and >300 s). In the patient with dysfunctional P2Y₁₂, closure time of INNOVANCE PFA P2Y was >300 s, while closure times of collagen/ADP and collagen/epinephrine were normal. Closure times of all cartridges were normal in the patient with heterozygous P2Y₁₂ deficiency.
  
  
  CONCLUSIONS
  Our study provides the first evidence that INNOVANCE PFA P2Y cartridge is sensitive to congenital severe and moderate defects of the platelet P2Y₁₂ receptors.
authors: Divisione di Medicina 3, Ospedale San Paolo - Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy.
authors: Mariangela
authors: M
authors: Scavone
authors: Divisione di Medicina 3, Ospedale San Paolo - Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy.
authors: Ksenia
authors: K
authors: Germanovich
authors: Divisione di Medicina 3, Ospedale San Paolo - Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy.
authors: Eti A
authors: EA
authors: Femia
authors: Divisione di Medicina 3, Ospedale San Paolo - Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy. Electronic address: marco.cattaneo@unimi.it.
authors: Marco
authors: M
authors: Cattaneo
mesh_terms: D000244:Adenosine Diphosphate / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D000368:Aged; D001792:Blood Platelets / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010979:Platelet Function Tests / Q000295:instrumentation*; D058925:Receptors, Purinergic P2Y12 / Q000378:metabolism*; D055815:Young Adult
chemical_list: D058925:Receptors, Purinergic P2Y12; D000244:Adenosine Diphosphate
keywords: ADP; Antiplatelet agents; CADP; CEPI; CT; HS; P2Y(12) defect; P2Y(12) purinoreceptor; PFA; PFA analyzer; PFA cartridges; PRI; Platelet function tests; VASP; adenosine diphosphate; closure time; collagen and ADP; collagen and epinephrine; healthy subjects; platelet function analyzer; platelet reactivity index; vasodilator-stimulated phosphoprotein