Assessment methods for aspirin-mediated platelet antiaggregation in type 2 diabetic patients: degree of correlation between 2 point-of-care methods.

Impaired response to antiplatelet therapy in diabetic patients results in a higher incidence of drug-eluting stent thrombosis. This study determined the prevalence of high on-aspirin (AS) platelet reactivity in type 2 diabetic patients treated with percutaneous coronary intervention (PCI) using the VerifyNow Aspirin Assay (VN) and platelet function analyzer PFA-100 (PFA-100) and analyzed the correlation between both methods.
Type 2 diabetic patients (100) with non-ST-elevation acute coronary syndrome who underwent PCI and Xience V drug-eluting stent implantation were included in this study. After PCI, platelet antiaggregation mediated by acetylsalicylic acid was assessed by VN and PFA-100. The degree of correlation and concordance was then determined.
When assayed with VN, 7% of the patients were nonresponders to aspirin (aspirin reaction units >550), and when assayed with PFA-10, 41% were nonresponders (closure time <193 seconds). Of the patients, 4% were nonresponders to aspirin according to VN but were sensitive to aspirin according to PFA-100, and 38% were sensitive to aspirin according to VN and nonresponders according to PFA-100. Overall, 55% of the patients were aspirin-sensitive in both methods. The Spearman's coefficient between VN and PFA-100 results was r = 0.09 (P = 0.35). The kappa index value was 0.0062 (P = 0.91).
There is no concordance or correlation between the VN and PFA-100 results. Therefore, the use of these analyses should be restricted to clinical research, which limits its application in clinical practice.
AuthorsJose M Cubero Gómez, María A Navarro Puerto, Juan Acosta Martínez, María I De Mier Barragán, Pastor L Pérez Santigosa, Francisco Sánchez Burguillos, Francisco Molano Casimiro, Luis Pastor Torres
JournalJournal of cardiovascular pharmacology (J Cardiovasc Pharmacol) Vol. 64 Issue 1 Pg. 16-20 (Jul 2014) ISSN: 1533-4023 [Electronic] United States
PMID24553145 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Platelet Aggregation Inhibitors
  • Aspirin
  • Aspirin (pharmacology, therapeutic use)
  • Diabetes Mellitus, Type 2 (drug therapy)
  • Drug-Eluting Stents
  • Female
  • Humans
  • Male
  • Percutaneous Coronary Intervention (methods)
  • Platelet Aggregation Inhibitors (pharmacology, therapeutic use)
  • Platelet Function Tests
  • Point-of-Care Systems
  • Prospective Studies
  • Statistics, Nonparametric

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