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ǥ : ȣ - 520695   66 
A head-to-head comparison between the VerifyNow P2Y12 assay and light transmittance aggregometry for assessing post-clopidogrel platelet reactivity in patients undergoing coronary stenting
경상대병원 순환기내과¹ , 경상대병원 진단검사 의학과 ²
정영훈¹, 최봉룡¹ ,김인숙² , 서명기¹ , 강민경¹, 곽충환¹, 황진용¹
Background: Greater platelet inhibition has resulted in a greater reduction of clinical outcomes in patients undergoing coronary stenting. Because of various limitations of traditional platelet function test, point-of-care (POC) platelet function tests have developed. However, there are limited data on correlations between the VerifyNow P2Y12 assay (VerifyNow) and traditional light transmittance aggregometry (LTA). Objectives and Methods: We compared VerifyNow values (PRU and % inhibition) with maximal and late platelet aggregation (AGGmax and AGGlate) induced by 5 and 20 ųM ADP in 554 patients undergoing stenting. We also could compare percent inhibition (PI) of PRU with PI of AGGmax and AGGlate in 150 patients. PI is defined as [(aggregation at baseline - aggregation at follow-up)/(aggregation at baseline)] X 100. Results: The 20 ųM ADP-induced AGG showed higher correlations with VerifyNow values compared with 5 ųM ADP-induced AGG (Table). In addition, AGGlate had a greater correlation with VerifyNow values than AGGmax. A stronger relationship was found between % inhibition and AGG than that of PRU and AGG. The optimal cut-off VerifyNow values for predicting high platelet reactivity (5 ųM ADP-induced AGGmax > 50%) was PRU ≥ 240 (AUC 0.808, 95% CI 0.770 – 0.846, P < 0.001) and % inhibition ≥ 21 (AUC 0.843, 95% CI 0.809 – 0.878, P < 0.001). PIs of PRU had acceptable and stronger correlations with PIs of 20 ųM ADP-induced AGG than those of 5 ųM ADP-induced AGG. Conclusions: Our results show a significant correlation between VerifyNow and LTA, which may suggest a substitutability of VerifyNow for assessing platelet inhibition in patients undergoing coronary stenting.

 

PRU

% inhibition

5 ųM ADP

 

 

   Aggmax

 

 

   Agglate

R = 0.653

P < 0.001

Y = 3.763X + 70.501

R = 0.657

P < 0.001

Y = 3.117X + 132.627

R = 0.690

P < 0.001

Y = -1.068X + 75.964

  R = 0.702

P < 0.001

Y = -0.895X + 58.641

20 ųM ADP

   Aggmax

 

 

   Agglate

 

 

 

R = 0.714

P < 0.001

Y = 3.954X + 9.181

R = 0.740

P < 0.001

Y = 2.955X + 98.822

 

R = 0.759

P < 0.001

Y = -1.1289X + 93.372

R = 0.785

P < 0.001

Y = -0.841X + 68.054

 

PI of PRU

 

5 ųM ADP

PI of Aggmax

 

 

PI of Agglate

 

 

20 ųM ADP

PI of Aggmax

 

 

PI of Agglate

 

 

 

R = 0.458

P < 0.001

Y = 0.410X + 20.334

R = 0.504

P < 0.001

Y = 0.322X + 17.609

 

R = 0.595

P < 0.001

Y = 0.657X + 15.946

R = 0.601

P < 0.001

Y = 0.417X + 14.362

 



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