title: Comparison of VerifyNow P2Y12 and thrombelastography for assessing clopidogrel response in stroke patients in China.
abstract: Poor response to clopidogrel is often associated with recurrent ischemic events, and reliable platelet function tests are needed to identify clopidogrel low response (CLR). The aim of the study was to compare the consistency of VerifyNow P2Y12 and thrombelastography (TEG) in acute ischemic stroke patients treated with clopidogrel. Patients hospitalized in Changhai Hospital from August 2012 to September 2013 and assigned to treatment with a daily 75-mg dose of clopidogrel. The blood samples were taken on the 5-7th day to assess the capability of VerifyNow P2Y12 and TEG for evaluation of clopidogrel response, and all instrument parameters were used to perform correlation analysis. Patients with CLR were detected by using the methods and criteria published earlier (PRU ≥ 230 assayed by VerifyNow P2Y12 or TEG-Inhib% ≤30 % measured by TEG). Totally 58 patients were enrolled for the study and there were wide varieties in parameters of VerifyNow P2Y12 and TEG. Results showed a total of 17 and 9 patients, respectively, identified as CLR assessed by VerifyNow P2Y12 and TEG, but only three patients were detected to be clopidogrel low responders with both tests. The kappa consistency analysis showed poor consistency between VerifyNow P2Y12 and TEG results in terms of CLR (Kappa = -0.0349, p = 0.7730). Linear regression also demonstrated poor correlation between VerifyNow-PRU/VerifyNow-Inhib% and TEG-Inhib% (p = 0.07901 and p = 0.3788, respectively). Our study demonstrated that there was poor correlation between VerifyNow P2Y12 and TEG results, and VerifyNow P2Y12 showed a larger proportion of CLR than TEG.
authors.affiliation: Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
authors.forename: Hui-Hui
authors.initials: HH
authors.lastname: Lv
authors.affiliation: Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Wu
authors.affiliation: State Key Laboratory of Genetic Engineering and Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, China.|Fudan Center for Genetic Epidemiology, School of Life Sciences, Fudan University, Shanghai, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
authors.forename: Xiao-Li
authors.initials: XL
authors.lastname: Yang
authors.affiliation: State Key Laboratory of Genetic Engineering and Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, China.|Fudan Center for Genetic Epidemiology, School of Life Sciences, Fudan University, Shanghai, China.|Program for Personalized Cancer Care, NorthShore University HealthSystem, Evanston, IL, USA.
authors.forename: Jian-Feng
authors.initials: JF
authors.lastname: Xu
authors.affiliation: Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Yang-Tai
authors.initials: YT
authors.lastname: Guan
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Dong
authors.affiliation: State Key Laboratory of Genetic Engineering and Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, China.|Fudan Center for Genetic Epidemiology, School of Life Sciences, Fudan University, Shanghai, China.|Program for Personalized Cancer Care, NorthShore University HealthSystem, Evanston, IL, USA.
authors.forename: S Lilly
authors.initials: SL
authors.lastname: Zheng
authors.affiliation: Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
authors.forename: Jian-Ming
authors.initials: JM
authors.lastname: Jiang
authors.affiliation: Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
authors.forename: Shi-Xu
authors.initials: SX
authors.lastname: Li
authors.affiliation: Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Luo
authors.affiliation: Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
authors.forename: Li-Xian
authors.initials: LX
authors.lastname: An
authors.affiliation: Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China. hanyan.2006@aliyun.com.
authors.forename: Yan
authors.initials: Y
authors.lastname: Han
mesh_terms: D000244:Adenosine Diphosphate / Q000097:blood; D000368:Aged; D002545:Brain Ischemia / Q000175:diagnosis* / Q000628:therapy*; D000077144:Clopidogrel; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D010979:Platelet Function Tests; D058921:Purinergic P2Y Receptor Antagonists / Q000097:blood; D020521:Stroke / Q000175:diagnosis* / Q000628:therapy*; D013916:Thrombelastography; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D000244:Adenosine Diphosphate; D000077144:Clopidogrel; D013988:Ticlopidine
keywords: Clopidogrel low response; Ischemic stroke; Thrombelastography; VerifyNow P2Y12