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ASSA13-11-4 The Clinical Application of VerifyNow-P2Y12 Assay in Evaluation of Platelet Inhibition with Clopidogrel
  1. Lin Shaoyi,
  2. Cui Hanbin,
  3. Chen Xiaomin
  1. Ningbo First Hopital

Abstract

Objective To evaluate the platelet inhibition with VerifyNow-P2Y12 assay in patients under regular maintenance dose of Clopidogrel, and explore the clinical characteristics of Clopidogrel non-responsive and its predicting factors.

Methods A total of 99 patients undergone PCI procedure and were receiving Clopidogrel in regular maintenance dose for at least 1 week were enrolled. Platelet reactivity, including Baseline, P2Y12 Reaction Unit (PRU), and platelet inhibition rate were measured with VeifyNow-P1Y12 assay (Accumetrics Inc., San Diego, CA, USA). The dosage of anti-platelet drugs, combination with any other drugs, clinical characters in baseline of all the enrolled patients was recorded in detail for evaluation. PRU ≤ 240 was used as cut-off to indentify Clopidogrel responsive and Clopidogrel non-responsive patients. In the non-responsive group, patients were further separated into 3 sub-groups (types) according to the baseline and platelet inhibition rate. Type I has high baseline, high inhibition rate, represents false non-responsiveness, Type II has low inhibition rate, represents true non-responsive, and Type III is combination.

Results In this study, 48 of 99 patients were found to be Clopidogrel non-responsive (48.5%). The ratio of Type I, Type II and Type III in the non-responsive group were 9(9.1%), 27(27.3%), and 12(12.1%), respectively. Female’s baseline value of platelet value was significantly higher than male’s (p < 0.01), number of females with high PRU also is high than males (p < 0.01), so female was a predict factor for Type I non-responsiveness (OR = 6.5, 95% CI 2.295 ∼ 18.407, P < 0.01). BMI > 24 kg/m2 show significant correlation with Clopidorgrel non-responsive (p < 0.05), and may be regarded as a predict factor for Type II non-responsiveness (OR = 3.207, 95% CI 1.375 ∼ 7.485, P < 0.01). Age, Hypertension, Diabetics, smoking, hyperlipidemia, CRP, and Pantoprazole do not show significant correlation with baseline and platelet inhibition rate.

Conclusions With VerifyNow-P2Y12 assay, Clopidogrel non-responsive Type I is caused by high baseline, and female patients is an independent predicting factor; Clopidogrel non-responsive Type II has true low platelet inhibition rate, related to the low effectiveness of Clopidogrel, high body weight may have some effects. Clopidogrel non-responsive Type III can have the characters of both type I and type II. Age, Hypertension, Diabetics, smoking, hyperlipidemia, CRP, and Pantoprazole do not relate to Clopidogrel non-responsive.

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