Relation between the vasodilator-stimulated phosphoprotein phosphorylation assay and light transmittance aggregometry in East Asian patients after high-dose clopidogrel loading

In Suk Kim, Young Hoon Jeong, Udaya S. Tantry, Yongwhi Park, Dong Hyun Lee, Kevin P. Bliden, Jin Sin Koh, Jeong Rang Park, Jae Sik Jang, Seok Jae Hwang, Eun Ha Koh, Choong Hwan Kwak, Jin Yong Hwang, Sunjoo Kim, Paul A. Gurbel

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives We analyzed the relation between platelet aggregation measured by light transmittance aggregometry (LTA) and platelet reactivity index (PRI) measured by vasodilator-stimulated phosphoprotein phosphorylation (VASP-P) assay. Background It has been suggested that LTA and VASP-P assay correlate differently according to the level of P2Y12 receptor blockade by thienopyridines. Methods We simultaneously measured platelet function by LTA and VASP-P assay in 466 East Asians undergoing elective percutaneous coronary intervention after a 600-mg clopidogrel loading. High on-clopidogrel platelet reactivity (HPR) was defined by published consensus criteria. Results The degree of correlation between LTA and the VASP-P assay was different according to PRI levels. The correlation was lower in patients with poor responsiveness (PRI >60%) (n = 216) (0.035 ≤ r2 ≤ 0.047), which was greater in responsive patients (PRI ≤60%) (n = 250) (0.315 ≤ r2 ≤ 0.526). Despite a 600-mg loading, East Asians had a high prevalence of HPR (40.1%-63.5%), and the prevalence of HPR also differed between LTA and VASP-P assay. A PRI cutoff of >58% (area under curve, 0.829; 95% confidence intervals, 0.792-0.862; P <.001) corresponded to the published HPR cutoff by 5-μM adenosine diphosphate-induced maximal platelet aggregation >46%. Conclusions This is the largest study correlating platelet reactivity measured by LTA and VASP-P assay in a percutaneous coronary intervention-treated cohort. The correlation is dependent on the level of responsiveness. Future investigations are needed to better define the optimal cutoffs of HPR measured by LTA and VASP-P assay for personalized antiplatelet therapy.

Original languageEnglish (US)
Pages (from-to)95-103
Number of pages9
JournalAmerican heart journal
Volume166
Issue number1
DOIs
StatePublished - Jul 2013

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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