Key result
PFA-200 P2Y closure time ≤ 106 seconds linked to ~7-fold higher MACE risk in clopidogrel-treated ACS.
Why the study?
Does the PFA-200 P2Y closure time predict major adverse cardiac events in Korean patients with recent-onset acute coronary syndrome taking clopidogrel?
Cohort (n=106)
No
Does the PFA-200 P2Y closure time predict major adverse cardiac events in Korean patients with recent-onset acute coronary syndrome taking clopidogrel?
Effect estimate: HR 7.30 (95% CI 2.07-25.82)
Absolute Event Rate: 25% vs 5.1%
p-value: p=0.002
The PFA-200 P2Y closure time is a strong predictor of major adverse cardiac events in Korean patients with recent-onset ACS receiving clopidogrel therapy.
May aid risk stratification in clopidogrel-treated ACS; leaves open whether PFA-200 testing improves outcomes in trials.
BACKGROUND: Clopidogrel is one of the most commonly used anti-platelet agents in cardiovascular diseases. We analyzed the relationship between the platelet function analyzer (PFA)-200 P2Y (INNOVANCE PFA-200 System, Siemens Healthcare, Germany) results and occurrence of major adverse cardiac events (MACEs) in Korean patients with recent-onset acute coronary syndrome (ACS) taking clopidogrel. METHODS: Between August 2013 and June 2016, we prospectively enrolled 106 patients with recent-onset ACS who had been treated with clopidogrel. We obtained blood samples and measured closure time (CT) using the PFA-200 P2Y test. Patients were divided into two groups on the basis of a CT cut-off value of 106 seconds. We compared patient characteristics and various MACEs that occurred during the follow-up period. RESULTS: The CTs for 78 patients exceeded the cut-off value. At the time of these analyses, 11 patients had been diagnosed with MACEs. In the time-to-event analysis, there was a difference between the two groups (P<0.001). After adjusting other variables associated with MACE occurrence, CT value was the strongest predictor of MACEs, with a 7.30-fold occurrence risk (P=0.002). CONCLUSIONS: We found a strong relationship between CT and MACE risk in Korean patients with recent-onset ACS taking clopidogrel. Accordingly, PFA-200 P2Y results could be used as a predictive marker for MACE risk in such patients.
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Lim et al. (2018) conducted a cohort in Acute coronary syndrome (n=106). PFA-200 P2Y closure time ≤ 106 seconds vs. PFA-200 P2Y closure time > 106 seconds was evaluated on Major adverse cardiac events (MACEs) (HR 7.30, 95% CI 2.07-25.82, p=0.002). A PFA-200 P2Y closure time ≤ 106 seconds was associated with a 7.30-fold increased risk of major adverse cardiac events compared to a closure time > 106 seconds in ACS patients taking clopidogrel.
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