Key result
ADP-induced platelet aggregation level (APAL) showed a higher correlation with P2Y12 reaction unit (r = 0.55, p < 0.01) than 10 µM ADP maximum aggregation (r = 0.42, p < 0.01) in neuroendovascular patients.
Why the study?
Confirming antiplatelet effects of P2Y12 inhibitors is clinically important, but standard protocols for evaluating these effects are currently unavailable.
Does APAL provide more reliable monitoring of antiplatelet effects than 10 µM ADP MA when compared to PRU in neuroendovascular patients?
Observational (n=124)
No
Does APAL provide more reliable monitoring of antiplatelet effects than 10 µM ADP MA when compared to PRU in neuroendovascular patients?
APAL derived through automated light transmission aggregometry correlates better with PRU than 10 µM ADP MA, offering a potentially reliable and cost-effective alternative for monitoring antiplatelet effects in neuroendovascular patients.
Confirming the antiplatelet effects of P2Y12 inhibitors is clinically important; although various methods exist for evaluating such antiplatelet effects, standard protocols are currently unavailable. We compared four platelet function tests in neuroendovascular patients performed based on two systems: (i) ADP-induced platelet aggregation level (APAL) and (ii) 10 µM ADP maximum aggregation (MA) using CN-6000, and (iii) P2Y12 reaction unit (PRU) as well as (iv) %inhibition using VerifyNow. Retrospective data of all 124 patients (median age 72 [26-92] years; 58.9% male) who received periprocedural antiplatelet therapy for elective neuroendovascular treatments between September 2020-December 2023 were evaluated. Blood samples were acquired the day before, immediately (1-3 days), and 1 month postoperatively, and during bleeding or thrombotic events. The results revealed changes over time in PRU, %inhibition, and APAL values, but not in 10 µM ADP MA. The correlation coefficient for PRU, the most widely used test in this setting, was higher with APAL (r = 0.55, p < 0.01) than with 10 µM ADP MA (r = 0.42, p < 0.01). An APAL result of 8.3 was equivalent to a PRU value of 240. In conclusion, APAL may provide more reliable monitoring of antiplatelet effects than 10 µM ADP MA-based monitoring and is worthy of further evaluation.
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Sakayori et al. (2025) conducted an observational in Elective neuroendovascular treatments requiring antiplatelet therapy (n=124). ADP-induced platelet aggregation level (APAL) vs. 10 µM ADP maximum aggregation (MA) was evaluated on Correlation with P2Y12 reaction unit (PRU) (r = 0.55, p=<0.01). ADP-induced platelet aggregation level (APAL) showed a higher correlation with P2Y12 reaction unit (r = 0.55, p < 0.01) than 10 µM ADP maximum aggregation (r = 0.42, p < 0.01) in neuroendovascular patients.
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