Four detection methods for antiplatelet function of clopidogrel: A comparative study / 第二军医大学学报

ABSTRACT

Objective To assess the consistencies of VerifyNow system, thrombelastography (TEG), vasodilator-stimulated phosphoprotein (VASP), and PL-11 platelet analyzer in detecting the antiplatelet function of clopidogrel, and to discuss the clinical application values. Methods Totally 98 consecutive inpatients with ST-segment elevation myocardial infarction (STEMI), non-(NSTEMI), or coronary artery in-stent restenosis (SR) were included in this study. The patients were given a loading dose of 600-mg clopidogrel for 6 hours, 300-mg clopidogrel for at 24 hours, or chronic clopidogrel therapy (75 mg daily for ≥ 7 days) before the procedure. And then the antiplatelet effects were evaluated by VerifyNow, TEG, VASP and PL-11 platelet analyzer simultaneously, with the results of VerifyNow taken as the gold standard and P2Y12 reaction unit (PRU) ≥ 208 taken as high on-clopidogel treatment platelet reactivity (HTPR). Correlation analysis was done for the four methods, and area under ROC curve (AUC) was used to evaluate the value of each method for HTPR. Results The platelet inhibition rate detected by VerifyNow was positively correlated with that by TEG (r = 0. 234, P < 0. 05); by contrast, it was negatively correlated with the platelet reactivity index (PRI) measured by VASP, the maximum platelet aggregation rate (MAR) by PL-11 and the maximum adenosine diphosphate (MA-ADP) by TEG (r = –0. 299, P<0. 01; r = –0. 330, P< 0.05; r = –0. 237, P<0. 05). The PRU values was negatively correlated with the platelet inhibition rate detected by VerifyNow (r = –0.815, P < 0. 01). The area under ROC curve of PL-11 platelet analyzer was the highest (0. 644). Conclusion TEG, VASP, and PL-11 platelet function testing systems all have consistency with the “gold standard” VerifyNow in some extent, with PL-11 platelet analyzer showing the highest sensitivity and specificity.