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Microfluidics in Assessing Platelet Function
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Platelet function testing in atrial fibrillation patients undergoing percutaneous coronary intervention
Ioannis Lianos1, Charalampos Varlamos1, Despoina-Rafailia Benetou1
12nd Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Rimini 1, Chaidari, 12462, Athens, Greece.
Journal of Thrombosis and Thrombolysis
|November 12, 2022
Summary
Platelet function testing (PFT) in atrial fibrillation (AF) patients undergoing percutaneous coronary intervention (PCI) showed ticagrelor led to lower platelet reactivity than clopidogrel. PFT results did not impact treatment decisions or predict bleeding events.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Atrial fibrillation (AF) patients undergoing percutaneous coronary intervention (PCI) require antithrombotic therapy.
- Individualized treatment guided by platelet function testing (PFT) is a potential strategy.
- Real-world data on PFT in this population are limited.
Purpose of the Study:
- To investigate platelet reactivity (PR) in AF patients on oral anticoagulants (OAC) undergoing PCI.
- To compare PR between clopidogrel and ticagrelor.
- To assess the impact of PFT on clinical decisions and outcomes.
Main Methods:
- Retrospective analysis of a nationwide, multicenter observational study.
- Included AF patients on OAC undergoing PCI, treated with clopidogrel or ticagrelor.
- Performed PFT before discharge and followed patients for 12 months.
Main Results:
- Ticagrelor resulted in significantly lower PR (46.02 PRU) compared to clopidogrel (162.9 PRU).
- High on-treatment PR (HTPR) was more common with clopidogrel (22.7%) than ticagrelor.
- Low on-treatment PR (LTPR) was more frequent with ticagrelor (80%) than clopidogrel (13.6%).
- PFT results did not influence aspirin prescription or predict bleeding events.
- Physician response to PFT results was variable.
Conclusions:
- Ticagrelor demonstrates superior platelet inhibition compared to clopidogrel in AF patients undergoing PCI.
- Current PFT protocols may not effectively guide antithrombotic therapy or predict outcomes in this patient group.
- Further research is needed to establish the clinical utility of PFT for personalized antithrombotic management.
