Prevalence of Ex Vivo High On-treatment Platelet Reactivity on Antiplatelet Therapy after Transient Ischemic Attack or Ischemic Stroke on the PFA-100(®) and VerifyNow(®).

Hdl Handle:
http://hdl.handle.net/10147/254549
Title:
Prevalence of Ex Vivo High On-treatment Platelet Reactivity on Antiplatelet Therapy after Transient Ischemic Attack or Ischemic Stroke on the PFA-100(®) and VerifyNow(®).
Authors:
Kinsella, Justin A; Tobin, W Oliver; Cox, Dermot; Coughlan, Tara; Collins, Ronan; O'Neill, Desmond; Murphy, Raymond P; McCabe, Dominick J H
Affiliation:
Department of Neurology, The Adelaide and Meath Hospital, incorporating the National Children's Hospital, Trinity College Dublin, Ireland.
Citation:
Prevalence of Ex Vivo High On-treatment Platelet Reactivity on Antiplatelet Therapy after Transient Ischemic Attack or Ischemic Stroke on the PFA-100(®) and VerifyNow(®). 2012: J Stroke Cerebrovasc Dis
Publisher:
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
Journal:
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
Issue Date:
12-Sep-2012
URI:
http://hdl.handle.net/10147/254549
DOI:
10.1016/j.jstrokecerebrovasdis.2012.07.012
PubMed ID:
22981273
Abstract:
BACKGROUND: The prevalence of ex vivo high on-treatment platelet reactivity (HTPR) to commonly prescribed antiplatelet regimens after transient ischemic attack (TIA) or ischemic stroke is uncertain. METHODS: Platelet function inhibition was simultaneously assessed with modified light transmission aggregometry (VerifyNow; Accumetrics Inc, San Diego, CA) and with a moderately high shear stress platelet function analyzer (PFA-100; Siemens Medical Solutions USA, Inc, Malvern, PA) in a pilot, cross-sectional study of TIA or ischemic stroke patients. Patients were assessed on aspirin-dipyridamole combination therapy (n = 51) or clopidogrel monotherapy (n = 25). RESULTS: On the VerifyNow, HTPR on aspirin was identified in 4 of 51 patients (8%) on aspirin-dipyridamole combination therapy (≥550 aspirin reaction units on the aspirin cartridge). Eleven of 25 (44%) patients had HTPR on clopidogrel (≥194 P2Y12 reaction units on the P2Y12 cartridge). On the PFA-100, 21 of 51 patients (41%) on aspirin-dipyridamole combination therapy had HTPR on the collagen-epinephrine (C-EPI) cartridge. Twenty-three of 25 patients (92%) on clopidogrel had HTPR on the collagen-adenosine diphosphate (C-ADP) cartridge. The proportion of patients with antiplatelet HTPR was lower on the VerifyNow than PFA-100 in patients on both regimens (P < .001). CONCLUSIONS: The prevalence of ex vivo antiplatelet HTPR after TIA or ischemic stroke is markedly influenced by the method used to assess platelet reactivity. The PFA-100 C-ADP cartridge is not sensitive at detecting the antiplatelet effects of clopidogrel ex vivo. Larger prospective studies with the VerifyNow and with the PFA-100 C-EPI and recently released Innovance PFA P2Y cartridges (Siemens Medical Solutions USA, Inc) in addition to newer tests of platelet function are warranted to assess whether platelet function monitoring predicts clinical outcome in ischemic cerebrovascular disease.
Item Type:
Article
Language:
en
ISSN:
1532-8511

Full metadata record

DC FieldValue Language
dc.contributor.authorKinsella, Justin Aen_GB
dc.contributor.authorTobin, W Oliveren_GB
dc.contributor.authorCox, Dermoten_GB
dc.contributor.authorCoughlan, Taraen_GB
dc.contributor.authorCollins, Ronanen_GB
dc.contributor.authorO'Neill, Desmonden_GB
dc.contributor.authorMurphy, Raymond Pen_GB
dc.contributor.authorMcCabe, Dominick J Hen_GB
dc.date.accessioned2012-12-05T13:16:26Z-
dc.date.available2012-12-05T13:16:26Z-
dc.date.issued2012-09-12-
dc.identifier.citationPrevalence of Ex Vivo High On-treatment Platelet Reactivity on Antiplatelet Therapy after Transient Ischemic Attack or Ischemic Stroke on the PFA-100(®) and VerifyNow(®). 2012: J Stroke Cerebrovasc Disen_GB
dc.identifier.issn1532-8511-
dc.identifier.pmid22981273-
dc.identifier.doi10.1016/j.jstrokecerebrovasdis.2012.07.012-
dc.identifier.urihttp://hdl.handle.net/10147/254549-
dc.description.abstractBACKGROUND: The prevalence of ex vivo high on-treatment platelet reactivity (HTPR) to commonly prescribed antiplatelet regimens after transient ischemic attack (TIA) or ischemic stroke is uncertain. METHODS: Platelet function inhibition was simultaneously assessed with modified light transmission aggregometry (VerifyNow; Accumetrics Inc, San Diego, CA) and with a moderately high shear stress platelet function analyzer (PFA-100; Siemens Medical Solutions USA, Inc, Malvern, PA) in a pilot, cross-sectional study of TIA or ischemic stroke patients. Patients were assessed on aspirin-dipyridamole combination therapy (n = 51) or clopidogrel monotherapy (n = 25). RESULTS: On the VerifyNow, HTPR on aspirin was identified in 4 of 51 patients (8%) on aspirin-dipyridamole combination therapy (≥550 aspirin reaction units on the aspirin cartridge). Eleven of 25 (44%) patients had HTPR on clopidogrel (≥194 P2Y12 reaction units on the P2Y12 cartridge). On the PFA-100, 21 of 51 patients (41%) on aspirin-dipyridamole combination therapy had HTPR on the collagen-epinephrine (C-EPI) cartridge. Twenty-three of 25 patients (92%) on clopidogrel had HTPR on the collagen-adenosine diphosphate (C-ADP) cartridge. The proportion of patients with antiplatelet HTPR was lower on the VerifyNow than PFA-100 in patients on both regimens (P < .001). CONCLUSIONS: The prevalence of ex vivo antiplatelet HTPR after TIA or ischemic stroke is markedly influenced by the method used to assess platelet reactivity. The PFA-100 C-ADP cartridge is not sensitive at detecting the antiplatelet effects of clopidogrel ex vivo. Larger prospective studies with the VerifyNow and with the PFA-100 C-EPI and recently released Innovance PFA P2Y cartridges (Siemens Medical Solutions USA, Inc) in addition to newer tests of platelet function are warranted to assess whether platelet function monitoring predicts clinical outcome in ischemic cerebrovascular disease.en_GB
dc.languageENG-
dc.language.isoenen
dc.publisherJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Associationen_GB
dc.rightsArchived with thanks to Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Associationen_GB
dc.titlePrevalence of Ex Vivo High On-treatment Platelet Reactivity on Antiplatelet Therapy after Transient Ischemic Attack or Ischemic Stroke on the PFA-100(®) and VerifyNow(®).en_GB
dc.typeArticleen
dc.contributor.departmentDepartment of Neurology, The Adelaide and Meath Hospital, incorporating the National Children's Hospital, Trinity College Dublin, Ireland.en_GB
dc.identifier.journalJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Associationen_GB
dc.description.provinceLeinsteren

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