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12 Assessment of individual responses to P2Y12 inhibitors: validation of a new point of care test & a novel rapid analysis
  1. Bartosz Olechowski1,2,
  2. Richard T Dalton2,
  3. Vikram Khanna1,2,
  4. Maria Vavyla1,
  5. Alexander Ashby2,
  6. Mark Mariathas1,2,
  7. Scott Harris2,
  8. Zoe Nicholas1,
  9. Michael Mahmoudi1,2,
  10. Nick Curzen1,2
  1. 1University Hospital Southampton NHS Foundation Trust
  2. 2Faculty of Medicine, University of Southampton

Abstract

Introduction There is potential value in testing individual response to P2Y12 inhibitors in order to predict ischaemic and bleeding risk in PCI patients. We aimed to:

a) validate the ability of a novel point of care (POC) assay using thrombelastography, TEG6s, to detect changes in ADP-induced whole blood clotting and

b) compare a novel, rapid test parameter, area under the curve at 15 min (AUC15), with the traditional maximum clot amplitude (MA).

Methods 25 participants were included in whom ADP-induced clotting was measured at 4 time points: a) 12 healthy volunteers given 600 mg of clopidogrel; b) 12 patients with ACS given 600 mg of clopidogrel; c) 1 healthy volunteer given 600 mg of clopidogrel on 5 separate occasions.

All samples were tested using traditional TEG5000 and the new point of care TEG6S.

Results

  • TEG 5000 and TEG 6 s detected changes in ADP–induced clotting. Bland Altman analysis demonstrated a good level of agreement between them [figure 1a].

  • For TEG6S, correlation between MA & our novel AUC15 was strong for both thrombin and ADP channels [figure 1b] (R=0.867, R=0.936, p<0.001), & the AUC15 result was available on average 13.3 mins earlier.

Conclusions TEG6s is a rapid, easy to use and accurate test of ADP-induced clotting using TEG5000 as a reference. A novel parameter, AUC15, is a viable and time saving option for this POC test.

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