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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Vasodilator-stimulated phosphoprotein phosphorylation analysis prior to percutaneous coronary intervention for

L Bonello1, F Paganelli, M Arpin-Bornet

  • 1Département de Cardiologie, Hôpital Universitaire Nord, Chemin des Bourrely, Marseille, France.

Journal of Thrombosis and Haemostasis : JTH
|May 10, 2007
PubMed

Insights

Vasodilator-stimulated phosphoprotein (VASP) analysis predicts major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI). This test effectively identifies patients at low risk for MACE, ensuring better clinical outcomes.

Area of Science:

  • Cardiology
  • Pharmacogenomics
  • Biomarker Discovery

Background:

  • High rates of major adverse cardiovascular events (MACE) persist despite dual antiplatelet therapy post-percutaneous coronary intervention (PCI).
  • Interindividual variability in clopidogrel response and its link to clinical outcomes are recognized.
  • Clopidogrel resistance is a significant concern in patients undergoing PCI.

Purpose of the Study:

  • To assess the predictive value of platelet reactivity index (PRI), measured by vasodilator-stimulated phosphoprotein (VASP) phosphorylation analysis, for MACE.
  • To determine the efficacy of VASP analysis in predicting post-PCI MACE.
  • To investigate VASP phosphorylation as a biomarker for clopidogrel response and MACE risk.

Main Methods:

  • Prospective monocentric study involving 144 patients undergoing PCI.
  • Platelet reactivity (PR) assessed by VASP phosphorylation 24 hours after a 300-mg clopidogrel loading dose.
  • MACE recorded over a 6-month follow-up period; patients stratified into PRI quintiles via VASP analysis.

Main Results:

  • A total of 144 patients with various coronary syndromes were included.
  • Twenty-one MACE occurred during follow-up; patients in the lowest VASP quintile had significantly lower MACE risk (P < 0.01).
  • Receiver operating characteristic (ROC) curve analysis identified an optimal VASP cut-off of 50% PR for excluding MACE, with 100% negative predictive value.

Conclusions:

  • VASP phosphorylation analysis is a valuable tool for assessing individual clopidogrel response before PCI.
  • This method effectively predicts postprocedural MACE in patients undergoing PCI.
  • VASP analysis offers a reliable method to identify patients at low risk for MACE, guiding therapeutic decisions.
Abstract

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