Abstract 18458: A Novel Flow-chamber System for Quantitative Assessment of Whole Blood Thrombogenicity in Patients Undergoing Elective Percutaneous Coronary Intervention
Accurate evaluation of the clotting ability is important for patients undergoing percutaneous coronary intervention (PCI) to prevent thrombotic or bleeding complications. Recently, the Total Thrombus-formation Analysis System (T-TAS) was developed for quantitative analysis of platelet thrombus formation (PTF) using microchips with thrombogenic surfaces (collagen, PL chip; collagen plus tissue factor, AR chip) under shear stress conditions. In the present study, we evaluated the usefulness of the T-TAS for the assessment of whole blood thrombogenicity in patients undergoing PCI treated with antiplatelet therapy (APT). Consecutive 160 patients were divided into 3 groups; patients without any antiplatelet therapy (Control, n=30), with single antiplatelet therapy treated with aspirin (SAPT, n=31), and with dual antiplatelet therapy treated with aspirin and clopidogrel (DAPT, n=99). Blood samples obtained on admission were applied to the T-TAS to measure PTF area under the curve (PL-AUC, area under curve until 10 min for PL chip; AR-AUC, 30 min for AR chip) under various shear rates (1500, 2000 s–1 for PL chip; 300 s–1 for AR chip). Platelet functions were also tested using VerifyNow system. PL-AUC levels decreased significantly in SAPT and DAPT compared with Control group, while the levels were significantly lower in DAPT compared with SAPT (SAPT: 280.9±83.2, DAPT: 118.3±87.8, and Control: 355.2±90.8, p<0.001 in SAPT or DAPT vs Control, p<0.001 in SAPT vs DAPT). There were no significant differences in AR-AUC levels among 3 groups. Next, we examined whether clinical parameters including the platelet function measured by T-TAS or VerifyNow system could predict the DAPT among patients with APT. Multiple logistic regression analysis identified the decrease of PL-AUC, AR-AUC, and P2Y12 reaction units (PRU) as significant predictors of DAPT. Receiver-operating characteristic (ROC) analysis showed that PL-AUC and PRU were significant predictors of DAPT state [AUC 0.900 (95%CI: 0.838 to 0.963; p<0.001), 0.846 (95%CI: 0.767-0.925; p<0.001), respectively]. Our results suggested that PL-AUC level measured by T-TAS might be an independent, powerful tool for the assessment of DAPT in patients undergoing PCI.
Author Disclosures: Y. Arima: None. K. Kaikita: None. T. Ono: None. S. Iwashita: None. M. Ito: None. M. Ishii: None. K. Tsujita: None. K. Sakamoto: None. E. Yamamoto: None. T. Tanaka: None. S. Kojima: None. S. Kojima: None. S. Hokimoto: None. H. Ogawa: Honoraria; Modest; AstraZeneca, Bayer, Pfizer, Sanofi, Takeda. Honoraria; Significant; Daiichi Sankyo, MSD. Other; Modest; AstraZeneca, Astellas, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Dainippon Sumitomo Pharma, Kowa, MSD, Novartis, Pfizer, Sanofi, Takeda. Other; Significant; Bayer, Chugai, Otsuka.
- © 2014 by American Heart Association, Inc.