학술논문
Abstract 11448: Time from Blood Draw to Multiple Electrode Aggregometry and Association with On-Clopidogrel Platelet Reactivity
Document Type
Article
Author
Source
Circulation (Ovid); November 2021, Vol. 144 Issue: Supplement 1 pA11448-A11448, 1p
Subject
Language
ISSN
00097322; 15244539
Abstract
Background:Guidelines consider platelet function testing to guide dual antiplatelet therapy (DAPT) de-escalation in selected patients. On-clopidogrel platelet reactivity as measured by multiple electrode aggregometry (MEA) varies according to patients′ characteristics but may also depend on pre-analytic factors.Purpose:This study aimed to analyze the association of time from blood draw to MEA results in patients undergoing percutaneous coronary intervention (PCI).Methods:In this observational single center cohort study, in patients undergoing PCI, all patients received DAPT with ASA and clopidogrel. Platelet aggregation (aggregation units, U) was quantified by MEA (Multiplate Analyzer) after stimulation with adenosine diphosphate (ADP; 6.4 μM in patients treated with ASA and clopidogrel following PCI. High on-clopidogrel platelet aggregation (HPR) was defined as ≥46 U. The manufacturer recommends performing the analysis within 30-180 min after blood draw. Thus, patients were grouped according to the time from blood draw to MEA: 1) 30-180 min 2) <30 min 3) >180 min.Results:Platelet function of 273 patients with coronary artery disease undergoing PCI with DAPT were analyzed. The median age was 72 years (interquartile range, IQR 62-79) and 179 (66%) were male. Median ADP-induced aggregation was 25 (IQR 18-36) U. HPR was observed in 34 patients (12%). Median time to MEA was 65 (IQR 45-113) min and 245 measurements (90%) were performed within 30-180 min as recommend by the manufacturer of the aggregometer. Compared with measurements performed within the manufacturers′ recommendations (25 [IQR 18-36] U, median ADP-induced aggregation was not significantly different if performed outside these recommendations (<30min: 24 [IQR 20-28] U, p=0.54; >180min: 25 [IQR 21-40] U, p=0.31). For those analyzed within 30-180 min from blood draw, no relevant correlation of time from blood draw to MEA with ADP-induced platelet aggregation was observed (r= - 0.04; p=0.51).Conclusion:In patients undergoing percutaneous coronary intervention and treated with dual antiplatelet therapy, the time from blood draw to multiple electrode aggregometry does not correlate with ADP-induced aggregation.