Platelet function measured by VerifyNow™ identifies generalized high platelet reactivity in aspirin treated patients

DiChiara, Joseph; Bliden, Kevin P.; Tantry, Udaya S.; Chaganti, Srivasavi K.; Kreutz, Rolf P.; Gesheff, Tania; Geshefe, Tania.A.; Kreutz, Yvonne; Gurbel, Paul A.

doi:10.1080/09537100701206824

Cited by 51 publications

(37 citation statements)

References 33 publications

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“…As users of high doses of aspirin (≥ 300 mg daily) show a lower HAPR prevalence than users of low doses (≤ 100 mg) [30], increasing the aspirin dose may reduce the number of HAPR patients [31][32][33][34][35][36][37][38][39][40][41]. It is debatable, however, whether improvement of HAPR with a higher aspirin dose reduces CVE risk.…”

Section: Apt For Patients With Haprmentioning

confidence: 99%

Platelet‐reactivity tests identify patients at risk of secondary cardiovascular events: a systematic review and meta‐analysis

Wisman

Roest

Asselbergs

et al. 2014

Journal of Thrombosis and Haemostasis

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To cite this article: Wisman PP, Roest M, Asselbergs FW, de Groot PG, Moll FL, van der Graaf Y, de Borst GJ. Platelet-reactivity tests identify patients at risk of secondary cardiovascular events: a systematic review and meta-analysis. J Thromb Haemost 2014; 12: 736-47.Summary. Background: Antiplatelet therapy is the standard treatment for the prevention of cardiovascular events (CVEs). High on-treatment platelet reactivity (HPR) is a risk factor for secondary CVEs in patients prescribed aspirin and/or clopidogrel. The present review and meta-analysis was aimed at assessing the ability of individual platelet-function tests to reliably identify patients at risk of developing secondary CVEs. Methods and Results: A systematic literature search was conducted to identify studies on platelet-reactivity measurements and CVEs. The main inclusion criteria were: (i) prospective study design; (ii) study medication, including aspirin and/ or clopidogrel; and (iii) a platelet-function test being performed at baseline, before follow-up started. Of 3882 identified studies, 102 (2.6%; reporting on 44 098 patients) were included in the meta-analysis. With regard to high on-aspirin platelet reactivity (HAPR), 22 different tests were discussed in 55 studies (22 441 patients). Pooled analysis showed that HAPR was diagnosed in 22.2% of patients, and was associated with an increased CVE risk (relative risk [RR] 2.09; 95% confidence interval [CI] 1.77-2.47). Eleven HAPR tests independently showed a significantly increased CVE risk in patients with HAPR as compared with those with normal on-aspirin platelet reactivity. As regards high on-clopidogrel platelet reactivity (HCPR), 59 studies (34 776 patients) discussed 15 different tests, and reported that HCPR was present in 40.4% of patients and was associated with an increased CVE risk (RR 2.80; 95% CI 2.40-3.27). Ten tests showed a significantly increased CVE risk. Conclusions: Patients with HPR are suboptimally protected against future cardiovascular complications. Furthermore, not all of the numerous platelet tests proved to be able to identify patients at increased cardiovascular risk.

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Section: Apt For Patients With Haprmentioning

confidence: 99%

Platelet‐reactivity tests identify patients at risk of secondary cardiovascular events: a systematic review and meta‐analysis

Wisman

Roest

Asselbergs

et al. 2014

Journal of Thrombosis and Haemostasis

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“…For Aspirin Assay, results are expressed as Aspirin Reaction Units (ARU) and for the identification of responsiveness to ASA treatment a specific cut-off value of 550 ARU is recommended by manufacturers [117] . In stroke patients on low dose of ASA [96] and in coronary artery disease patients on dual antiplatelet therapy [65,46,118] a moderate agreement between VerifyNow system and LTA results was observed. For the VerifyNow P2Y12 assay results are expressed as P2Y12 Reaction Units (PRU).…”

Section: Verifynow Systemmentioning

confidence: 80%

Assessment of platelet function: Laboratory and point-of-care methods

Paniccia¹

2014

WJTM

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In the event of blood vessel damage, human platelets are promptly recruited on the site of injury and, after their adhesion, activation and aggregation, prevent blood loss with the formation of a clot. The consequence of abnormal regulation can be either hemorrhage or the development of thrombosis. Qualitative and/or quantitative defects in platelets promote bleeding, whereas the residual reactivity of platelets, despite antiplatelet therapies, play an important role in promoting arterial thrombotic complications. Platelet function is traditionally assessed to investigate the origin of a bleeding syndrome, to predict the risk of bleeding prior surgery or during pregnancy or to monitor the efficacy of antiplatelet therapy in thrombotic syndromes that, now, can be considered a new discipline. "Old" platelet function laboratory tests such as the evaluation of bleeding time and the platelet aggregation analysis in platelet-rich plasma are traditionally utilized to aid in the diagnosis and management of patients with platelet and hemostatic disorders and used as diagnostic tools both in bleeding and thrombotic diathesis in specialized laboratories. Now, new and renewed automated systems have been introduced to provide a simple, rapid assessment of platelet function including point of care methods. These new methodologies are also suitable for being used in non-specialized laboratories and in critical area for assessing platelet function in whole blood without the requirement of sample processing. Some of these methods are also beginning to be incorporated into routine clinical use and can be utilized as not only as first panel for the diagnosis of platelet dysfunction, but also for monitoring anti-platelet therapy and to potentially assess risk of both bleeding and/or thrombosis.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Platelets; Method; Test; Point of care testing; Laboratory assessment; Bleeding; Thrombosis; Platelet function Core tip: This review discussed the scenario of available platelet function laboratory and point-of-care methods suitable in different clinical setting. As this matter has become of crucial importance in the bleeding management and for monitoring antiplatelet therapies, improved ability to assess platelet function in a timely and efficient manner is essential. Traditional platelet function methods, requiring a fair degree of expertise, have been limited to specialized laboratory. Many efforts have been carried out for improving platelet function assays for centralized laboratory, such as different point-of-care testing methodologies have been developed. Moreover, different guidelines and recommendations for their method standardization are growing.

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“…The Accumetrics VerifyNow is an automated whole blood assay that measures agglutination of fibrinogen-coated beads in response to specific agonists (60,67). Platelet function measured by VerifyNow is said to identify generalised high platelet reactivity in aspirintreated patients (70). However, issues regarding the lack of reproducibility of assessment of aspirin responsiveness have been One may criticise that PFA-100 is not platelet-specific but is influenced by VWF (42).…”

Section: Clinical Focusmentioning

confidence: 99%

Assessment of platelets and the endothelium in patients presenting with acute coronary syndromes – is there a future?

Derhaschnig¹,

Jilma²

2009

Thromb Haemost

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Platelet function measured by VerifyNow™ identifies generalized high platelet reactivity in aspirin treated patients

Cited by 51 publications

References 33 publications

Platelet‐reactivity tests identify patients at risk of secondary cardiovascular events: a systematic review and meta‐analysis

Platelet‐reactivity tests identify patients at risk of secondary cardiovascular events: a systematic review and meta‐analysis

Assessment of platelet function: Laboratory and point-of-care methods

Assessment of platelets and the endothelium in patients presenting with acute coronary syndromes – is there a future?

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