Background Various platelet function testing are used to evaluate the response to antiplatelet therapy and its correlation with clinical outcomes. Light transmission aggregometry (LTA) remains the ‘gold standard’ of platelet function testing. However, it is labor-intensive assays and relatively expense. The point-of-care (POC) platelet function assays have been developed for use in routine clinical practice. A new method, called multiple electrode platelet aggregometry (MEA), to rapidly measure platelet aggregation in whole blood, has been developed recently. However, whether the results obtained with MEA correlate well with LTA is unknown in Korean.
Methods We compared the results of MEA and LTA in blood donated by healthy volunteers. The subjects received aspirin 300 mg and clopidogrel 600 mg (dual antiplatelet regimen) at first and then, we added the cilostazol 200mg on dual antiplatelet regimen. The tests were performed at baseline, 1, 2, 4, 6, 8 and 10 hours after the initial dual antiplatelet regimen and we repeated the same tests after adding cilostazol on it. We used the following cut-off points for high post-treatment platelet reactivity (HPPR): 5 umol/l ADP-induced PRmax ≥ 50%; 20 umol/l ADP-induced PRmax ≥ 50% by LTA and area under curve of arbitrary unit (AUC) ≥ 468 AUㆍmin by MEA.
Results The results of MEA significantly correlated with those of 5 umol/l ADP-induced PRmax and 20 umol/l ADP-induced PRmax (R2 = 0.423 and R2 = 0.468 at each, P < 0.001 of all). AUC ≥ 468 AUㆍmin showed a moderate agreement with 5 umol/l ADP-induced PRmax ≥ 50% (Κ = 0.515, concordant rate 80.1%, P < 0.001) and with 20 umol/l ADP-induced PRmax ≥50% by LTA (Κ = 0.530, concordant rate 78.5%, P < 0.001). Receiver operating characteristics (ROC) curve analysis of the MEA demonstrated that cut-offs matched for 5 umol/l ADP-induced PRmax ≥ 50% and 20 umol/l ADP-induced PRmax ≥50% were 405.0 and 383.5 AUㆍmin respectively.
Conclusion The results of MEA had significant correlation and moderate agreement with those of LTA. Therefore, MEA, the new point-of-care platelet function testing, can be used for the risk stratification in patients treated with percutaneous coronary intervention.
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