Background: Data on the agreement between light transmission aggregometry (LTA) and multiple electrode aggregometry (MEA) in patients on the more potent P2Y₁₂ inhibitors are missing so far.

Aims: Therefore, we investigated if the evaluation of the responsiveness to therapy by LTA can be replaced by MEA in 160 acute coronary syndrome (ACS) patients on dual antiplatelet therapy with aspirin and prasugrel or ticagrelor (n=80 each).

Methods: Platelet aggregation was measured using adenosine diphosphate (ADP) or arachidonic acid (AA) as agonists. Cut-off values for high on-treatment residual platelet reactivity (HRPR) to ADP and AA were defined according to previous studies showing an association of HRPR with the occurrence of adverse ischemic outcomes.

Results: ADP-inducible platelet reactivity by MEA correlated significantly with LTA ADP in prasugrel-treated patients (r=0.4, p<0.001), but not in those receiving ticagrelor (r=0.09; p=0.45). AA-inducible platelet aggregation by LTA and MEA did not correlate in prasugrel- and ticagrelor-treated patients. Sensitivity/specificity of HRPR by MEA to detect HRPR by LTA were 25%/99% for MEA ADP and 100%/79% for MEA AA in prasugrel-treated patients, and 0%/100% for MEA ADP and 70%/83% for MEA AA in ticagrelor-treated patients.

Conclusions: On-treatment residual ADP-inducible platelet reactivity by LTA and MEA shows a significant correlation in prasugrel- but not ticagrelor-treated patients. However, in both groups LTA and MEA revealed heterogeneous results regarding the classification of patients as responders or non-responders to P2Y₁₂ inhibition. Accordingly, these tests are not interchangeable in the assessment of the response to antiplatelet therapy in ACS patients undergoing PCI. 
 

« Back to ISTH 2021 Congress

ISTH Congress Abstracts - https://abstracts.isth.org/abstract/comparison-of-platelet-function-tests-during-p2y12-inhibition/