Lv Hui-Hui, Wu Shuai, Liu Xu, Yang Xiao-Li, Xu Jian-Feng, Guan Yang-Tai, Dong Qiang, Zheng S Lilly, Jiang Jian-Ming, Li Shi-Xu, Luo Zheng, Li Li, An Li-Xian, Han Yan
Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
State Key Laboratory of Genetic Engineering and Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, China.
Neurol Sci. 2016 Feb;37(2):277-82. doi: 10.1007/s10072-015-2407-7. Epub 2015 Oct 31.
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.
氯吡格雷反应不佳常与复发性缺血事件相关，因此需要可靠的血小板功能测试来识别氯吡格雷低反应（CLR）。本研究的目的是比较VerifyNow P2Y12和血栓弹力图（TEG）在接受氯吡格雷治疗的急性缺血性卒中患者中的一致性。2012年8月至2013年9月在长海医院住院并接受每日75毫克氯吡格雷治疗的患者。在第5 - 7天采集血样，以评估VerifyNow P2Y12和TEG评估氯吡格雷反应的能力，并使用所有仪器参数进行相关性分析。采用先前发表的方法和标准（通过VerifyNow P2Y12检测PRU≥230或通过TEG检测TEG-Inhib%≤30%）检测CLR患者。共有58例患者纳入本研究，VerifyNow P2Y12和TEG的参数存在很大差异。结果显示，分别有17例和9例患者通过VerifyNow P2Y12和TEG评估为CLR，但两种检测方法均检测出只有3例患者为氯吡格雷低反应者。kappa一致性分析显示，VerifyNow P2Y12和TEG在CLR结果方面一致性较差（Kappa = -0.0349，p = 0.7730）。线性回归也显示VerifyNow-PRU/VerifyNow-Inhib%与TEG-Inhib%之间相关性较差（分别为p = 0.07901和p = 0.3788）。我们的研究表明，VerifyNow P2Y12和TEG结果之间相关性较差，且VerifyNow P2Y12显示的CLR比例高于TEG。
