Ann Lab Med.  2018 Sep;38(5):413-419. 10.3343/alm.2018.38.5.413.

Platelet Function Analyzer-200 P2Y Results Are Predictive of the Risk of Major Adverse Cardiac Events in Korean Patients Receiving Clopidogrel Therapy Following Acute Coronary Syndrome

• Lim HH
• Li S
• An GD
• Woo KS
• Kim KH
• Kim JM
• Kim MH
• Han JY

• KMID: 2434729
• DOI: http://doi.org/10.3343/alm.2018.38.5.413

Abstract

BACKGROUND
Clopidogrel is one of the most commonly used anti-platelet agents in cardiovascular diseases. We analyzed the relationship between the platelet function analyzer (PFA)-200 P2Y (INNOVANCE PFA-200 System, Siemens Healthcare, Germany) results and occurrence of major adverse cardiac events (MACEs) in Korean patients with recent-onset acute coronary syndrome (ACS) taking clopidogrel.
METHODS
Between August 2013 and June 2016, we prospectively enrolled 106 patients with recent-onset ACS who had been treated with clopidogrel. We obtained blood samples and measured closure time (CT) using the PFA-200 P2Y test. Patients were divided into two groups on the basis of a CT cut-off value of 106 seconds. We compared patient characteristics and various MACEs that occurred during the follow-up period.
RESULTS
The CTs for 78 patients exceeded the cut-off value. At the time of these analyses, 11 patients had been diagnosed with MACEs. In the time-to-event analysis, there was a difference between the two groups (P<0.001). After adjusting other variables associated with MACE occurrence, CT value was the strongest predictor of MACEs, with a 7.30-fold occurrence risk (P=0.002).
CONCLUSIONS
We found a strong relationship between CT and MACE risk in Korean patients with recent-onset ACS taking clopidogrel. Accordingly, PFA-200 P2Y results could be used as a predictive marker for MACE risk in such patients.

Keyword

PFA-200 P2Y test; Clopidogrel; Major adverse cardiac events

MeSH Terms

Acute Coronary Syndrome*
Blood Platelets*
Cardiovascular Diseases
Delivery of Health Care
Follow-Up Studies
Humans
Prospective Studies

Figure

• 

  Fig. 1 Closure time (CT) value distribution of the overall group (the horizontal line indicates the analytical cut-off value of 106 seconds) and both groups separately (the horizontal lines indicate mean values and error bars indicate 95% confidence intervals).

• 

  Fig. 2 Kaplan-Meier cumulative event-free curves for Group A (closure time value >106 seconds) and Group B (closure time value ≤106 seconds). Each event is indicated by arrows.

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