Comparative study of four platelet function tests conducted using two systems in neuroendovascular patients

Area of Science:

• Neuroendovascular medicine
• Clinical pharmacology
• Platelet function testing

Background:

• Confirming P2Y12 inhibitor antiplatelet effects is vital in neuroendovascular procedures.
• Standardized protocols for platelet function testing are currently lacking.
• Various methods exist, but their comparative reliability in this patient population is unclear.

Purpose of the Study:

• To compare the performance of four platelet function tests in neuroendovascular patients.
• To evaluate the reliability of ADP-induced platelet aggregation level (APAL) and 10 µM ADP maximum aggregation (MA) monitoring.
• To assess changes in platelet function over time and in relation to clinical events.

Main Methods:

• Retrospective analysis of 124 neuroendovascular patients receiving antiplatelet therapy.
• Comparison of ADP-induced platelet aggregation level (APAL) and 10 µM ADP maximum aggregation (MA) using CN-6000.
• Evaluation of P2Y12 reaction unit (PRU) and %inhibition using VerifyNow.
• Blood samples collected pre-procedure, post-procedure (1-3 days, 1 month), and during events.

Main Results:

• PRU, %inhibition, and APAL values showed changes over time, unlike 10 µM ADP MA.
• PRU demonstrated a higher correlation with APAL (r=0.55, p<0.01) than with 10 µM ADP MA (r=0.42, p<0.01).
• An APAL result of 8.3 was found to be equivalent to a PRU value of 240.

Conclusions:

• ADP-induced platelet aggregation level (APAL) may offer more reliable monitoring of P2Y12 inhibitor effects than 10 µM ADP MA.
• APAL warrants further investigation for its clinical utility in neuroendovascular patients.
• Standardized platelet function testing remains an unmet clinical need.