Dominick J. Angiolillo, MD, PhD, University of Florida College of Medicine-Jacksonville, 655 West 8th Street, Jacksonville, FL, 32209, USA, Tel: +1 904 244 3933, Fax: +1 904 244 3102, E-mail:
Thromb Haemost. 2016 Nov 30;116(6):1060-1069. doi: 10.1160/TH16-05-0377. Epub 2016 Aug 4.
Several platelet function tests (PFT) are available to assess the pharmacodynamic (PD) effects of P2Y inhibitors. However, there are technical variances between PFT, and P2Y inhibitors differ in pharmacological properties. Manufactures of PFT recommend a time-frame within which assessments needs to be executed. However, if the timing from blood sampling to processing affects PD results is unknown. We conducted a prospective study assessing the impact of timing from blood sampling to processing on PD measures using three different PFT. We studied 60 aspirin-treated patients with coronary artery disease (CAD) on maintenance P2Y inhibiting therapy [clopidogrel 75 mg/day (n=20), prasugrel 10 mg/day (n=20) and ticagrelor 90 mg bid (n=20)]. PD assessments (trough levels) were performed by VerifyNow P2Y12 (VN), light transmittance aggregometry (LTA) and vasodilator-stimulated phosphoprotein (VASP) at 30 minutes, 2 and 4 hours post-sampling; VASP was also performed at 24 hours. P2Y reaction units (PRU) by VN significantly decreased over time with all P2Y inhibitors (clopidogrel p<0.001; prasugrel p=0.016; ticagrelor p<0.001). PRU at 30 minutes and 2 hours were similar, but decreased at 4 hours. LTA showed consistent findings with VN. Conversely, PD measures as assessed by VASP were stable over time (p>0.1 for all P2Y inhibitors). In conclusion, in CAD patients on maintenance therapy with P2Y inhibitors, timing from blood sampling to processing significantly influences PD measures as assessed by VN and LTA, but not by VASP.
有几种血小板功能测试（PFT）可用于评估 P2Y 抑制剂的药效学（PD）效应。然而，PFT 之间存在技术差异，且 P2Y 抑制剂在药理学特性上存在差异。PFT 的制造商建议在一定的时间框架内进行评估。然而，如果从采血到处理的时间会影响 PD 结果则尚不清楚。我们进行了一项前瞻性研究，使用三种不同的 PFT 评估从采血到处理的时间对 PD 测量的影响。我们研究了 60 例接受阿司匹林治疗的冠心病（CAD）患者，他们正在接受维持性 P2Y 抑制治疗[氯吡格雷 75mg/天（n=20），普拉格雷 10mg/天（n=20）和替格瑞洛 90mg 每日两次（n=20）]。PD 评估（谷水平）通过 VerifyNow P2Y12（VN）、光透射聚集测定（LTA）和血管扩张刺激磷蛋白（VASP）在采血后 30 分钟、2 小时和 4 小时进行；VASP 还在 24 小时进行。所有 P2Y 抑制剂的 VN 检测的 P2Y 反应单位（PRU）均随时间显著降低（氯吡格雷 p<0.001；普拉格雷 p=0.016；替格瑞洛 p<0.001）。30 分钟和 2 小时的 PRU 相似，但 4 小时时降低。LTA 与 VN 有一致的发现。相反，VASP 评估的 PD 测量在整个时间内保持稳定（所有 P2Y 抑制剂的 p>0.1）。总之，在接受维持性 P2Y 抑制剂治疗的 CAD 患者中，从采血到处理的时间显著影响 VN 和 LTA 评估的 PD 测量，但不影响 VASP。
