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Comparison of VerifyNow P2Y12 and thrombelastography for assessing clopidogrel response in stroke patients in China

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Abstract

Poor response to clopidogrel is often associated with recurrent ischemic events, and reliable platelet function tests are needed to identify clopidogrel low response (CLR). The aim of the study was to compare the consistency of VerifyNow P2Y12 and thrombelastography (TEG) in acute ischemic stroke patients treated with clopidogrel. Patients hospitalized in Changhai Hospital from August 2012 to September 2013 and assigned to treatment with a daily 75-mg dose of clopidogrel. The blood samples were taken on the 5–7th day to assess the capability of VerifyNow P2Y12 and TEG for evaluation of clopidogrel response, and all instrument parameters were used to perform correlation analysis. Patients with CLR were detected by using the methods and criteria published earlier (PRU ≥ 230 assayed by VerifyNow P2Y12 or TEG-Inhib% ≤30 % measured by TEG). Totally 58 patients were enrolled for the study and there were wide varieties in parameters of VerifyNow P2Y12 and TEG. Results showed a total of 17 and 9 patients, respectively, identified as CLR assessed by VerifyNow P2Y12 and TEG, but only three patients were detected to be clopidogrel low responders with both tests. The kappa consistency analysis showed poor consistency between VerifyNow P2Y12 and TEG results in terms of CLR (Kappa = −0.0349, p = 0.7730). Linear regression also demonstrated poor correlation between VerifyNow-PRU/VerifyNow-Inhib% and TEG-Inhib% (p = 0.07901 and p = 0.3788, respectively). Our study demonstrated that there was poor correlation between VerifyNow P2Y12 and TEG results, and VerifyNow P2Y12 showed a larger proportion of CLR than TEG.

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Acknowledgments

The authors thank all the volunteers participating in the study. This study was supported by National Natural Science Foundation of China (No. 81100847), Shanghai Pujiang Program (No. 14PJC002) and an intramural grant by Changhai Hospital (CH125531900).

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    Authors and Affiliations

    1. Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China

      Hui-Hui Lv, Shuai Wu, Xiao-Li Yang, Jian-Ming Jiang, Shi-Xu Li, Zheng Luo, Li Li, Li-Xian An & Yan Han

    2. State Key Laboratory of Genetic Engineering and Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, China

      Xu Liu, Jian-Feng Xu & S. Lilly Zheng

    3. Fudan Center for Genetic Epidemiology, School of Life Sciences, Fudan University, Shanghai, China

      Xu Liu, Jian-Feng Xu & S. Lilly Zheng

    4. Program for Personalized Cancer Care, NorthShore University HealthSystem, Evanston, IL, USA

      Jian-Feng Xu & S. Lilly Zheng

    5. Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China

      Qiang Dong

    6. Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

      Yang-Tai Guan

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    1. Hui-Hui Lv
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    Correspondence to Yan Han.

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    H.-H. Lv and S. Wu contributed equally to the work.

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    Lv, HH., Wu, S., Liu, X. et al. Comparison of VerifyNow P2Y12 and thrombelastography for assessing clopidogrel response in stroke patients in China. Neurol Sci 37, 277–282 (2016). https://doi.org/10.1007/s10072-015-2407-7

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    • DOI: https://doi.org/10.1007/s10072-015-2407-7

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