정영훈 (Sinai Center for Thrombosis Research, 현 중앙대학교 광명병원) | 상위피인용논문 > 한빛사

상위피인용논문

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Sinai Center for Thrombosis Research, 현 중앙대학교 광명병원

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Am. Heart J., Jul 2012, 164 (1) | https://doi.org/10.1016/j.ahj.2012.03.022 Usefulness of the VerifyNow P2Y12 assay to evaluate the antiplatelet effects of ticagrelor and clopidogrel therapies

Young-Hoon Jeong ¹, Kevin P Bliden ¹, Mark J Antonino ¹, Ki-Soo Park ², Udaya S Tantry ¹, Paul A Gurbel ^{1 *}

¹Sinai Center for Thrombosis Research, Baltimore, MD, USA.
²Department of Preventive medicine, Gyeongsang national university, Jinju, South Korea

^*Corresponding author: correspondence to Paul A Gurbel

Abstract

Objectives
We analyzed the antiplatelet effects of different P2Y12 receptor blockers with VerifyNow P2Y12 assay (VN-P2Y12) and light transmittance aggregometry (LTA).

Background
The point-of-care VN-P2Y12 has been used to assess the antiplatelet effects in clopidogrel-treated patients but has not been evaluated in detail in patients treated with ticagrelor.

Methods
Patients were randomly assigned to either ticagrelor [180 mg loading/90 mg twice daily (n = 37)] or clopidogrel [600 mg loading/75 mg daily (n = 39)] on top of aspirin treatment, and platelet reactivity was measured serially during onset, maintenance, and offset phases. High on-treatment platelet reactivity (HPR) was defined as 5 and 20 μM adenosine diphosphate-induced maximal platelet aggregation ≥46% and ≥59%, respectively, and P2Y12 reaction units ≥235.

Results
Platelet function measured by VN-P2Y12 correlated well with LTA (.812 ≤ ρ ≤ .823, P < .001). VN-P2Y12 “BASE” values were consistent during administration of both agents. Calculated and reported percent inhibitions by VN-P2Y12 were similar (difference, −0.6%; 95% agreement limits, −22.9% to 21.6%). Platelet inhibition by VN-P2Y12 during clopidogrel and ticagrelor administrations was comparable to platelet inhibition by LTA. HPR determined by LTA and VN-P2Y12 were well matched, and the risk stratification between the two methods showed strong agreement after both therapies (κ > .7).

Conclusions
The VerifyNow P2Y12 assay is effective in assessing the antiplatelet effects and in identifying HPR during clopidogrel or ticagrelor therapy.

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