Point of Care Tests VerifyNow P2Y12 and INNOVANCE PFA P2Y Compared to Light Transmittance Aggregometry After Fibrinolysis

• Published in: Clinical and applied thrombosis/hemostasis 2018-10, Vol.24 (7), p.1109-1116
• Main Authors: Roule, Vincent, Ardouin, Pierre, Repessé, Yohan, Le Querrec, Agnès, Blanchart, Katrien, Lemaitre, Adrien, Sabatier, Rémi, Borel-Derlon, Annie, Beygui, Farzin
• Format: Article
• Language: English
• Subjects: Blood platelets; Female; Fibrinolysis; Heart attacks; Humans; Male; Middle Aged; Original; Platelet Aggregation - drug effects; Platelet Aggregation Inhibitors - pharmacology; Platelet Aggregation Inhibitors - therapeutic use; Point of care testing; Point-of-Care Systems - standards; Prospective Studies
• ISSN: 1076-0296; 1938-2723
• DOI: 10.1177/1076029618772354

Detection of high on-treatment platelet reactivity (HPR) by point-of-care tests has not been validated after successful fibrinolysis for ST-elevation myocardial infarction. We assessed the validity of the point-of-care VerifyNow P2Y12 (VN) and INNOVANCE PFA P2Y (PFA) tests on HPR compared to light transmittance aggregometry (LTA) in these patients. The HPR was identified in 10 (34.5%) patients, 15 (51.7%) patients, and 14 (50%) patients using LTA, VN, and PFA, respectively. Discrepancies were observed between the tests despite significant correlations between platelet reactivity measures by LTA and VN (r = 0.74; P < .0001) and LTA and PFA (r = .75; P < .0001). Compared to LTA, VN and PFA were associated with a 92% and 53% and 92% and 64% positive predictive value (PPV) and negative predictive value (NPV), respectively, in detecting HPR. When combined, VN and PFA results yielded 90% and 100% PPV and NPV values if discrepancies between the 2 tests were considered as non-HPR. The VN or PFA identify patients without HPR correctly but overestimate the proportion of HPR patients. The association of the 2 tests, in case of HPR, improves the accuracy of the detection of HPR.