Details

Autor(en) / Beteiligte

• Varenhorst, Christoph
• James, Stefan
• Erlinge, David
• Braun, Oscar Ö.
• Brandt, John T.
• Winters, Kenneth J.
• Jakubowski, Joseph A.
• Olofsson, Sylvia
• Wallentin, Lars
• Siegbahn, Agneta

Titel

Assessment of P2Y12 inhibition with the point-of-care device VerifyNow P2Y12 in patients treated with prasugrel or clopidogrel coadministered with aspirin

Ist Teil von

• The American heart journal, 2009-03, Vol.157 (3), p.562-562.e9

Ort / Verlag

Philadelphia: Elsevier Limited

Erscheinungsjahr

2009

Link zum Volltext

Quelle

Elsevier ScienceDirect Journals Complete

Beschreibungen/Notizen

• Background Variability in response to thienopyridines has led to the development of point-of-care devices to assess adenosine diphosphate (ADP)-induced platelet aggregation. These tests need to be evaluated in comparison to reference measurements of P2Y12function during different thienopyridine treatments. Methods After a run-in on 75 mg aspirin, 110 subjects were randomized to double-blind treatment with clopidogrel 600 mg loading dose (LD)/75 mg maintenance dose (MD) or prasugrel 60 mg LD/10 mg MD. Antiplatelet effects were evaluated by VerifyNowP2Y12 (VN-P2Y12) device (Accumetrics, San Diego, CA), vasodilator-stimulated phosphoprotein (VASP) phosphorylation assay, and light transmission aggregometry (LTA). Prasugrel's and clopidogrel's active metabolite concentration were also determined. Results Dose- and time-dependent inhibition of P2Y12was evident with VN-P2Y12. There was strong correlation with VN-P2Y12 and VASP or LTA for all treatments through a wide range of P2Y12function. At high levels of P2Y12inhibition, platelet function measured by VN-P2Y12 was maximally inhibited and could not reflect further changes seen with VASP or LTA methods. Correlation was also observed between exposure to clopidogrel's active metabolite and VN-P2Y12 during MD and LD, whereas it was observed only with prasugrel MD. Conclusion The VN-P2Y12 correlated strongly with inhibition of P2Y12function, as measured with either VASP or LTA. VN-P2Y12 also correlated to exposure to the active metabolite of prasugrel and clopidogrel up to levels associated with assumed saturation of the P2Y12receptor.