Abstract Number: PB1395
Meeting: ISTH 2020 Congress
Background: :. Patients scheduled for intracranial flow diversion shunts ( Pipeline embolization device,PED) are at risk for thromboembolic events (TEE) and in-stent thrombosis (ST) with potential catastrophic consequences and are routinely prescribed aspirin and ant-P2Y12 drugs. Ensuring the presence of inhibition of the P2Y12 receptors is of important but the choice of test remains enigmatic.
Aims: To compare the results of platelet function testing in patients taking anti-P2Y12 drugs prior to PED using whole blood impedance (WBI) , light transmission aggregometry (LTA) and the VerifyNow device (VND)
Methods: Citrated whole blood samples were collected from patients prior to PED. All samples were studied within 3 hours. WBI and LTA were performed using diluted whole blood and Platelet rich plasma, respectively, at 5 mM ADP. Inhibition was defined as < 5 Ohms for WBI, less than 40% aggregation for LTA and less than 195 PRUs in the VND. Data were assessed for concordance (all tests in agreement) or discordance (difference in interpretation between tests).
Results: 99 patients had 113 tests performed, the overwhelming majority taking 75 mg clopidogrel daily. Concordance was observed in 77 /113 (70%) of which 57/77 (75%) showed inhibition and 20/77 (25%) showed resistance. All patients showing resistance had their anti-P2Y12 therapy altered and were retested. 36/113 (30%) patients showed discordant results between tests and decisions regarding therapy and retesting individualized. Correlation between test results were low despite statistical significant ( WBI v VND , r = 0.49, p < 0.01; WBI v LTA, r = 0.5, p < 0.01; LTA v VND, r = 0.49, p < 0.01) . All patients underwent PED procedures and there were no TEEs or ST.
Conclusions: Testing platelet function for P2Y12 resistance in the case of PED placement identifies resistant patients but using a single test may not be the optimal strategy
To cite this abstract in AMA style:Gergi M, McTaggart R, Cheves T, Sweeney J. Comparison of Platelet Function Testing in Patients Undergoing Neuroradiological Flow Diversion Stents [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/comparison-of-platelet-function-testing-in-patients-undergoing-neuroradiological-flow-diversion-stents/. Accessed January 21, 2022.
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