Abstract 13870: Defining the Predictive Values of Three Different Platelet Function Testing for The Status of the Cyp2c19 Phenotype in Patients Undergoing Percutaneous Coronary Intervention
Introduction: Published data suggests that the carrying of loss of function (LOF) CYP2C19*2 or *3 alleles is indicative of increased residual platelet aggregation and a higher risk of adverse cardiovascular events even after clopidogrel administration. We sought to calculate the cut-off values of 3 different assays for the prediction of CYP2C19 carriers LOF allele in Korean patients who had undergone percutaneous coronary intervention.
Methods: We enrolled 244 consecutive patients who had undergone PCI with drug-eluting stent implantation and chronic clopidogrel plus aspirin maintenance therapy. Platelet reactivity was assessed with light transmittance aggregometry (LTA), multiple electrode aggregometry (MEA) and the VerifyNow P2Y12 assay (VN) and CYP2C19 genotype was analyzed.
Results: The frequency of the CYP2C19 carrier LOF allele was 58.6%. The cut-off values from LTA, MEA and VerifyNow for the identification of LOF carriers allele were as follows: 10 µM ADP induced LTA ≥48 %, MEA ≥37 AUC and VerifyNow >242 PRU. Between the three tests, correlation was between LTA vs. VerifyNow assays (r=0.69) and LTA vs. MEA (r=0.56), with moderate agreement (κ=0.46 and κ=0.46), but use whole blood both devices shows low correlation (r=0.42) and agreement (κ=0.3).
Conclusion: Our results provide guidance for cut-off levels for LTA, MEA and VerifyNow assays to detect carriers of CYP2C19 LOF allele.
- © 2012 by American Heart Association, Inc.