Cor Vasa 2016, 58(4):e411-e418 | DOI: 10.1016/j.crvasa.2015.11.004

Platelet function testing after acute myocardial infarction: The correlation among various assays is insufficient

Radomír Nykl^a,*, Jiří Plášek^b, Tomáš Fürst^c, Jana Fürstová^d, Jaromír Gumulec^e, Karin Lichá^e, Miroslav Homza^b

^a Kardiovaskulární oddělení, Fakultní nemocnice Ostrava, Ostrava, Česká republika

^b Kardiovaskulární oddělení, Fakultní nemocnice Ostrava a Lékařská fakulta Ostravské univerzity v Ostravě, Ostrava, Česká republika

^c Katedra matematické analýzy a aplikací matematiky, Přírodovědecká fakulta Univerzity Palackého, Olomouc, Česká republika

^d 1. lékařská fakulta Univerzity Karlovy, Praha, Česká republika

^e Ústav klinické hematologie, Fakultní nemocnice Ostrava, Ostrava, Česká republika

Aim: High on-treatment platelet reactivity (HPR) after Acetylsalicylic acid (ASA) and/or Clopidogrel was identified by four different platelet function assays in high risk acute myocardial infarction patients. Correlation among the methods was examined and variability in the measurement of each platelet function assay was evaluated.

Methods: Each of the 53 patients was sampled twice for LTA, PFA-100/200, Multiplate®, and VerifyNow® platelet function assays in the range of 3-5 days after a myocardial infarction. Non-parametric correlation and linear regression were used to assess the variability in the data.

Results: All HPR platelet function assays for Clopidogrel are significantly correlated, however, the correlation values are only moderate. The correlation among the four assays for ASA is generally low and insignificant. Low reproducibility of HPR measurements and no significant correlation between Troponin I value and HPR were observed, both for ASA and Clopidogrel. No significant correlation between the type of acute coronary syndrome and HPR was observed, both for ASA and Clopidogrel.

Conclusion: At least two methods to identify HPR are recommended. The average of at least two measurements is recommended for any assay.

Keywords: Acetylsalicylic acid; Clopidogrel; Dual antiplatelet therapy; High on-treatment platelet reactivity; Myocardial infarction; Reproducibility

Received: September 30, 2015; Revised: November 9, 2015; Accepted: November 13, 2015; Published: August 1, 2016  Show citation