Abstract Number: PB1401
Meeting: ISTH 2020 Congress
Theme: Platelet Disorders and von Willebrand Disease » Antiplatelet Therapy
Background: Observational studies demonstrated that high on-treatment platelet reactivity is associated with an increased risk for adverse cardiovascular events in patients (pts) after percutaneous coronary intervention (PCI). Earlier, in experiments in vitro, we have shown the inverse association of platelet reactivity (PRU) measured by the VerifyNow P2Y12 assay with plasma fibrinogen (Fg) levels and suggested a formula for correcting of Fg effect [Biochemistry (Moscow) 2016; 81: 439-44].
Aims: This study sought to examine whether adjusting for plasma Fg level improves the predictive value of PRU for ischemic events following PCI.
Methods: A total of 317 pts (61±10 years) with stable coronary artery disease on dual antiplatelet therapy after elective PCI were enrolled. Platelet reactivity was measured using VerifyNow P2Y12 cartridges (Accumetrics, USA), and Fg (g/l) – by the clotting assay of Clauss. Fibrinogen-adjusted PRU (Fg-PRU) was calculated according to formula: Fg-PRU=PRU (measured) + 54*
(patient Fg – 3.2).
Results: At 1-year follow-up thrombotic events occurred in 18 pts and 23 pts received repeat revascularization. Both measured PRU and Fg levels were numerically higher in pts with thrombotic events or composite end point than in those without adverse events, although the differences were not statistically significant (Table). Correcting PRU for plasma Fg significantly increased the magnitude of difference in PRU values between pts with and without adverse events. The ROC analysis showed that Fg-PRU levels significantly discriminated between patients with and without adverse events (AUC: 0.624; 95 % CI: 0.534 to 0.715; p=0.01) and Fg-PRU value ≥199 was identified as the optimal cut-off to predict ischemic outcomes with sensitivity of 56.1% and specificity of 60.5%.
Conclusions: Correcting PRU for Fg, which itself is a risk factor for CVD, improves the value of the VerifyNow P2Y12 assay in identification of pts at high risk of ischemic events following PCI.
Without adverse events, n=276 | Thrombotic events, n=18 | Composite end point, n=41 | |
Fibrinogen, g/l | 3.39 [2.99-3.83] | 3.58 [3.10-4.0], p=0.197 | 3.60 [3,19-3.90], p=0.090 |
PRU | 175 [124-206] | 192 [150-208], p=0.088 | 196 [149-223], p=0.061 |
Fg-PRU | 182 [131-230] | 217 [180-249], p=0.039 | 210 [172-252], p=0.010 |
[Platelet reactivity and ischemic outcomes after PCI]
To cite this abstract in AMA style:
Dobrovolsky A, Laguta P, Titaeva E, Komarov A, Novikova E, Guskova E, Yarovaya E, Panchenko E. The Effect of Plasma Fibrinogen Level on Predictive Value of VerifyNow P2Y12 Assay Results in Patients Undergoing Percutaneous Coronary Interventions [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/the-effect-of-plasma-fibrinogen-level-on-predictive-value-of-verifynow-p2y12-assay-results-in-patients-undergoing-percutaneous-coronary-interventions/. Accessed May 1, 2024.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/the-effect-of-plasma-fibrinogen-level-on-predictive-value-of-verifynow-p2y12-assay-results-in-patients-undergoing-percutaneous-coronary-interventions/