Platelet function tests may provide modest benefit in predicting cardiac outcomes

February 23, 2010

An analysis of six tests that are used to measure platelet function and help gauge the effectiveness of antiplatelet drugs for patients undergoing a cardiac procedure such as a coronary stent implantation found that only three of the tests were associated with a modest ability to predict outcomes such as heart attack or death, according to a study in the February 24 issue of JAMA.

Dual antiplatelet therapy with aspirin and (antiplatelet agent used to inhibit ) reduces atherothrombotic (vascular obstruction) complications in patients undergoing percutaneous (PCI; procedures such as balloon angioplasty or stent placement used to open narrowed coronary arteries) with stenting. However, the individual response to dual antiplatelet therapy is not uniform, according to background information in the article. There currently is no consensus regarding the most appropriate method to quantify the magnitude of effect an antiplatelet agent may have on platelet reactivity.

Nicoline J. Breet, M.D., of St. Antonius Hospital and St. Antonius Center for Platelet Function Research, Nieuwegein, the Netherlands, and colleagues conducted a study to evaluate the ability of multiple platelet function tests to predict atherothrombotic events, including stent (blood clot within the stent), in 1,069 clopidogrel-pretreated patients undergoing elective coronary stent implantation. Using blood samples, platelet reactivity was measured in parallel with six platelet function tests. The primary outcome measured was a composite of all-cause death, nonfatal heart attack, stent thrombosis and .

The researchers found that at 1-year follow-up, the primary outcome occurred more frequently in patients with high platelet reactivity when assessed by the tests light transmittance aggregometry, VerifyNow and Plateletworks, which also had modest ability to discriminate between patients having and not having a primary event. The three other testing methods (IMPACT-R, Dade PFA collagen/ADP, and Innovance PFA P2Y) were unable to discriminate between patients with and without the primary outcome. None of the tests identified patients at risk for bleeding.

"In conclusion, of the platelet function tests assessed, only light transmittance aggregometry, VerifyNow, and Plateletworks were significantly associated with the primary end point. However, the predictability of these 3 tests was only modest. None of the tests provided accurate prognostic information to identify patients at higher risk of bleeding. Thus, [this study] does not support the use of platelet function testing to guide clinical practice in a low-risk population of patients undergoing elective PCI," the authors write.

More information: JAMA. 2010;303[8]:754-762.

Related Stories

Recommended for you

Drug found that induces apoptosis in myofibroblasts reducing fibrosis in scleroderma

December 15, 2017
(Medical Xpress)—An international team of researchers has found that the drug navitoclax can induce apoptosis (self-destruction) in myofibroblasts in mice, reducing the spread of fibrosis in scleroderma. In their paper ...

How defeating THOR could bring a hammer down on cancer

December 14, 2017
It turns out Thor, the Norse god of thunder and the Marvel superhero, has special powers when it comes to cancer too.

Researchers track muscle stem cell dynamics in response to injury and aging

December 14, 2017
A new study led by researchers at Sanford Burnham Prebys Medical Discovery Institute (SBP) describes the biology behind why muscle stem cells respond differently to aging or injury. The findings, published in Cell Stem Cell, ...

'Human chronobiome' study informs timing of drug delivery, precision medicine approaches

December 13, 2017
Symptoms and efficacy of medications—and indeed, many aspects of the human body itself—vary by time of day. Physicians tell patients to take their statins at bedtime because the related liver enzymes are more active during ...

Study confirms link between the number of older brothers and increased odds of being homosexual

December 12, 2017
Groundbreaking research led by a team from Brock University has further confirmed that sexual orientation for men is likely determined in the womb.

Potassium is critical to circadian rhythms in human red blood cells

December 12, 2017
An innovative new study from the University of Surrey and Cambridge's MRC Laboratory of Molecular Biology, published in the prestigious journal Nature Communications, has uncovered the secrets of the circadian rhythms in ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.