Comparison of conventional aggregomerty with VASP for monitoring P2Y12-specifc platelet inhibition

Dániel Aradi, Tamás Magyarlaki, Margit Tökés-Füzesi, Orsolya Rideg, András Vorobcsuk, András Komócsi

Research output: Article

16 Citations (Scopus)

Abstract

No consensus exists regarding the optimal estimate of light transmission aggregometry (LTA) to reflect P2Y12 ADP receptor inhibition in patients receiving thienopyridine therapy. Currently, the only completely P2Y12-receptor specific method is the measurement of vasodilator stimulated phosphoprotein (VASP) phosphorylation (PRI) with flow cytometry. In the current analysis, we aimed to test the superiority of the late platelet aggregation value over other estimates of light transmission aggregometry in determining P2Y12-receptor inhibition by comparing them to VASP-PRI. On-clopidogrel platelet reactivity was measured in 121 clopidogrel-nave patients who underwent elective coronary stent implantation. Samples for LTA and VASP assessments were drawn at 1218 hours after a 600-mg loading dose of clopidogrel and 25 days after the intervention. ADP 5 M-induced maximal aggregation (AGGmax), 6-minute late aggregation (AGGlate), 6-minute disaggregation (disAGG) and area under the aggregation curve (AUC) were compared to VASP-PRI. Categorical agreement with VASP-defined normal and high platelet reactivity (HPR: PRI≥50) was calculated according to the optimal cutoff values obtained with receiver-operating characteristic (ROC) curves. The evaluation of 242 measurements showed significant, moderate-strength correlations between VASP-PRI and LTA estimates without the superiority of AGGlate over other estimates (AGGmax: 0.47; AGGlate: 0.45; disAGG: -0.44; AUC: 0.50). Notably, there were considerable intra-individual differences between VASP and LTA testing. LTA estimates were similar in classifying patients to VASP-defined normal or HPR categories (AGGmax: 0.41; AGGlate: 0.45; disAGG: 0.44; AUC: 0.44). When all estimates of LTA were compared in multivariable models, AUC proved to be the independent linear determinant of VASP-PRI and the best predictor of HPR. Estimates of LTA seem equal in determining the degree of P2Y12-receptor inhibition or in predicting VASP-defined HPR without the superiority of AGGlate over others. These results reject a commonly used hypothesis and might contribute to the standardization of the LTA assay.

Original languageEnglish
Pages (from-to)563-570
Number of pages8
JournalPlatelets
Volume21
Issue number7
DOIs
Publication statusPublished - nov. 2010

Fingerprint

Blood Platelets
clopidogrel
Light
Phosphorylation
Area Under Curve
vasodilator-stimulated phosphoprotein
Inhibition (Psychology)
Purinergic P2 Receptors
Platelet Aggregation
Individuality
ROC Curve
Adenosine Diphosphate
Stents
Consensus
Flow Cytometry

ASJC Scopus subject areas

  • Hematology

Cite this

Comparison of conventional aggregomerty with VASP for monitoring P2Y12-specifc platelet inhibition. / Aradi, Dániel; Magyarlaki, Tamás; Tökés-Füzesi, Margit; Rideg, Orsolya; Vorobcsuk, András; Komócsi, András.

In: Platelets, Vol. 21, No. 7, 11.2010, p. 563-570.

Research output: Article

Aradi, Dániel ; Magyarlaki, Tamás ; Tökés-Füzesi, Margit ; Rideg, Orsolya ; Vorobcsuk, András ; Komócsi, András. / Comparison of conventional aggregomerty with VASP for monitoring P2Y12-specifc platelet inhibition. In: Platelets. 2010 ; Vol. 21, No. 7. pp. 563-570.
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