Usefulness of the VerifyNow P2Y12 assay to evaluate the antiplatelet effects of ticagrelor and clopidogrel therapies

Young Hoon Jeong, Kevin P. Bliden, Mark J. Antonino, Ki Soo Park, Udaya S. Tantry, Paul A. Gurbel

Research output: Contribution to journalArticle

Abstract

Objectives: We analyzed the antiplatelet effects of different P2Y 12 receptor blockers with VerifyNow P2Y12 assay (VN-P2Y12) and light transmittance aggregometry (LTA). Background: The point-of-care VN-P2Y12 has been used to assess the antiplatelet effects in clopidogrel-treated patients but has not been evaluated in detail in patients treated with ticagrelor. Methods: Patients were randomly assigned to either ticagrelor [180 mg loading/90 mg twice daily (n = 37)] or clopidogrel [600 mg loading/75 mg daily (n = 39)] on top of aspirin treatment, and platelet reactivity was measured serially during onset, maintenance, and offset phases. High on-treatment platelet reactivity (HPR) was defined as 5 and 20 μM adenosine diphosphate-induced maximal platelet aggregation ≥46% and ≥59%, respectively, and P2Y12 reaction units ≥235. Results: Platelet function measured by VN-P2Y12 correlated well with LTA (.812 ≤ ρ ≤ .823, P < .001). VN-P2Y12 "BASE" values were consistent during administration of both agents. Calculated and reported percent inhibitions by VN-P2Y12 were similar (difference, -0.6%; 95% agreement limits, -22.9% to 21.6%). Platelet inhibition by VN-P2Y12 during clopidogrel and ticagrelor administrations was comparable to platelet inhibition by LTA. HPR determined by LTA and VN-P2Y12 were well matched, and the risk stratification between the two methods showed strong agreement after both therapies (κ > .7). Conclusions: The VerifyNow P2Y12 assay is effective in assessing the antiplatelet effects and in identifying HPR during clopidogrel or ticagrelor therapy.

Original languageEnglish (US)
Pages (from-to)35-42
Number of pages8
JournalAmerican heart journal
Volume164
Issue number1
DOIs
StatePublished - Jul 1 2012

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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