Key result
Point-of-care P2Y12 assays correlate moderately with LTA but overestimate high on-treatment platelet reactivity.
Why the study?
Do point-of-care tests VerifyNow P2Y12 and INNOVANCE PFA P2Y accurately detect high on-treatment platelet reactivity compared to light transmittance aggregometry in patients after successful fibrinolysis for STEMI?
Cross-Sectional (n=30)
Do point-of-care tests VerifyNow P2Y12 and INNOVANCE PFA P2Y accurately detect high on-treatment platelet reactivity compared to light transmittance aggregometry in patients after successful fibrinolysis for STEMI?
Point-of-care tests VerifyNow P2Y12 and INNOVANCE PFA P2Y overestimate high on-treatment platelet reactivity after STEMI fibrinolysis, but their combined use improves diagnostic accuracy.
Answers are grounded in this paper and cite their sources.
Overestimation by VerifyNow and PFA cautions against standalone HPR assessment post-fibrinolysis; leaves open combined testing in larger prospective cohorts.
Detection of high on-treatment platelet reactivity (HPR) by point-of-care tests has not been validated after successful fibrinolysis for ST-elevation myocardial infarction. We assessed the validity of the point-of-care VerifyNow P2Y12 (VN) and INNOVANCE PFA P2Y (PFA) tests on HPR compared to light transmittance aggregometry (LTA) in these patients. The HPR was identified in 10 (34.5%) patients, 15 (51.7%) patients, and 14 (50%) patients using LTA, VN, and PFA, respectively. Discrepancies were observed between the tests despite significant correlations between platelet reactivity measures by LTA and VN ( r = 0.74; P < .0001) and LTA and PFA ( r = .75; P < .0001). Compared to LTA, VN and PFA were associated with a 92% and 53% and 92% and 64% positive predictive value (PPV) and negative predictive value (NPV), respectively, in detecting HPR. When combined, VN and PFA results yielded 90% and 100% PPV and NPV values if discrepancies between the 2 tests were considered as non-HPR. The VN or PFA identify patients without HPR correctly but overestimate the proportion of HPR patients. The association of the 2 tests, in case of HPR, improves the accuracy of the detection of HPR.
No takes yet. Share an insight, caveat, or question.
Roule et al. (2018) conducted a cross-sectional in ST-elevation myocardial infarction (STEMI) successfully treated by fibrinolysis (n=30). VerifyNow P2Y12 and INNOVANCE PFA P2Y point-of-care tests vs. Light transmittance aggregometry (LTA) was evaluated on Correlation between platelet reactivity measures by VerifyNow P2Y12 and light transmittance aggregometry (r = 0.74, p=<0.0001). VerifyNow P2Y12 and INNOVANCE PFA P2Y significantly correlated with light transmittance aggregometry (r=0.74 and r=0.75, respectively) but overestimated the proportion of patients with high on-treatment platelet reactivity.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: