Assessment methods for aspirin-mediated platelet antiaggregation in type 2 diabetic patients: degree of correlation between 2 point-of-care methods

J Cardiovasc Pharmacol. 2014 Jul;64(1):16-20. doi: 10.1097/FJC.0000000000000084.

Abstract

Aims: Impaired response to antiplatelet therapy in diabetic patients results in a higher incidence of drug-eluting stent thrombosis. This study determined the prevalence of high on-aspirin (AS) platelet reactivity in type 2 diabetic patients treated with percutaneous coronary intervention (PCI) using the VerifyNow Aspirin Assay (VN) and platelet function analyzer PFA-100 (PFA-100) and analyzed the correlation between both methods.

Methods: Type 2 diabetic patients (100) with non-ST-elevation acute coronary syndrome who underwent PCI and Xience V drug-eluting stent implantation were included in this study. After PCI, platelet antiaggregation mediated by acetylsalicylic acid was assessed by VN and PFA-100. The degree of correlation and concordance was then determined.

Results: When assayed with VN, 7% of the patients were nonresponders to aspirin (aspirin reaction units >550), and when assayed with PFA-10, 41% were nonresponders (closure time <193 seconds). Of the patients, 4% were nonresponders to aspirin according to VN but were sensitive to aspirin according to PFA-100, and 38% were sensitive to aspirin according to VN and nonresponders according to PFA-100. Overall, 55% of the patients were aspirin-sensitive in both methods. The Spearman's coefficient between VN and PFA-100 results was r = 0.09 (P = 0.35). The kappa index value was 0.0062 (P = 0.91).

Conclusions: There is no concordance or correlation between the VN and PFA-100 results. Therefore, the use of these analyses should be restricted to clinical research, which limits its application in clinical practice.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aspirin / pharmacology
  • Aspirin / therapeutic use*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Drug-Eluting Stents
  • Female
  • Humans
  • Male
  • Percutaneous Coronary Intervention / methods*
  • Platelet Aggregation Inhibitors / pharmacology
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Platelet Function Tests
  • Point-of-Care Systems*
  • Prospective Studies
  • Statistics, Nonparametric

Substances

  • Platelet Aggregation Inhibitors
  • Aspirin