title: Impact of timing from blood sampling to pharmacodynamic assessment on measures of platelet reactivity in patients treated with P2Y12receptor inhibitors.
abstract: Several platelet function tests (PFT) are available to assess the pharmacodynamic (PD) effects of P2Y12inhibitors. However, there are technical variances between PFT, and P2Y12inhibitors differ in pharmacological properties. Manufactures of PFT recommend a time-frame within which assessments needs to be executed. However, if the timing from blood sampling to processing affects PD results is unknown. We conducted a prospective study assessing the impact of timing from blood sampling to processing on PD measures using three different PFT. We studied 60 aspirin-treated patients with coronary artery disease (CAD) on maintenance P2Y12inhibiting therapy [clopidogrel 75 mg/day (n=20), prasugrel 10 mg/day (n=20) and ticagrelor 90 mg bid (n=20)]. PD assessments (trough levels) were performed by VerifyNow P2Y12 (VN), light transmittance aggregometry (LTA) and vasodilator-stimulated phosphoprotein (VASP) at 30 minutes, 2 and 4 hours post-sampling; VASP was also performed at 24 hours. P2Y12reaction units (PRU) by VN significantly decreased over time with all P2Y12inhibitors (clopidogrel p<0.001; prasugrel p=0.016; ticagrelor p<0.001). PRU at 30 minutes and 2 hours were similar, but decreased at 4 hours. LTA showed consistent findings with VN. Conversely, PD measures as assessed by VASP were stable over time (p>0.1 for all P2Y12inhibitors). In conclusion, in CAD patients on maintenance therapy with P2Y12inhibitors, timing from blood sampling to processing significantly influences PD measures as assessed by VN and LTA, but not by VASP.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Rollini
authors.forename: Francesco
authors.initials: F
authors.lastname: Franchi
authors.forename: Kamaldeep
authors.initials: K
authors.lastname: Singh
authors.forename: Jung Rae
authors.initials: JR
authors.lastname: Cho
authors.forename: Mona
authors.initials: M
authors.lastname: Bhatti
authors.forename: Christopher
authors.initials: C
authors.lastname: DeGroat
authors.forename: Jenny
authors.initials: J
authors.lastname: Hu
authors.forename: Niti
authors.initials: N
authors.lastname: Aggarwal
authors.forename: Zeina
authors.initials: Z
authors.lastname: Alobaidi
authors.forename: Estela
authors.initials: E
authors.lastname: Thano
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Ferrante
authors.forename: Martin
authors.initials: M
authors.lastname: Zenni
authors.forename: Theodore A
authors.initials: TA
authors.lastname: Bass
authors.affiliation: Dominick J. Angiolillo, MD, PhD, University of Florida College of Medicine-Jacksonville, 655 West 8th Street, Jacksonville, FL, 32209, USA, Tel: +1 904 244 3933, Fax: +1 904 244 3102, E-mail: dominick.angiolillo@jax.ufl.edu.
authors.forename: Dominick J
authors.initials: DJ
authors.lastname: Angiolillo
mesh_terms: D000241:Adenosine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000328:Adult; D001792:Blood Platelets / Q000187:drug effects*; D015815:Cell Adhesion Molecules; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008840:Microfilament Proteins; D008875:Middle Aged; D010750:Phosphoproteins; D010974:Platelet Aggregation; D010975:Platelet Aggregation Inhibitors; D010979:Platelet Function Tests; D000068799:Prasugrel Hydrochloride / Q000627:therapeutic use; D011446:Prospective Studies; D058921:Purinergic P2Y Receptor Antagonists / Q000627:therapeutic use*; D000077486:Ticagrelor; D013988:Ticlopidine / Q000627:therapeutic use; D013997:Time Factors; D000098662:Vasodilator-Stimulated Phosphoprotein
chemical_list: D015815:Cell Adhesion Molecules; D008840:Microfilament Proteins; D010750:Phosphoproteins; D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D000098662:Vasodilator-Stimulated Phosphoprotein; D000068799:Prasugrel Hydrochloride; D000077486:Ticagrelor; D000241:Adenosine; D013988:Ticlopidine
keywords: Clopidogrel; prasugrel; sample collection and sample processing; ticagrelor