Jul 5 2012
Participants: what method, if any, do you use for monitoring Plavix? The ones I know about are light transmittance aggregometry using ADP as the agonist, impedance aggregometry with ADP, INNOVANCE PFA-100 P2Y ( RUO), Accumetrics Integra VerifyNow P2Y12, the Multiplate analyzer (RUO), or the thromboelastograph (TEG). If you are using one of the point of care methods, such as PFA-100 or VerifyNow, how do you validate the assay?
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Antiplatelet Therapy
In our method validation for LTA, WBA, PFA-100 and Accumetri
In our method validation for LTA, WBA, PFA-100 and Accumetrics aggregometry we performed the following protocol for all 4 systems simultaneously. This is because we were doing a research study to validate the Siemens PFA-100 INNOVANCE P2Y12 cartridge. This study was published in Blood Coagulation and Fibrinolysis 2011;22:583-7. Twenty normal subjects who were not taking any meds that would affect their coagulation parameters were tested to establish a normal range. Siemens provided us a cut-off of 20% inhibition with a PRU of 106 seconds; LTA with 20uM of ADP: 50% amplitude; WBA using 5uM ADP: 5 ohms and 10uM: 8 ohms. All of these ranges were performed on at least 20 normal subjects. The 600 and 300 mg Plavix group only had 5 individuals. The study had many more subjects but the initial validation of clopidogrel response was performed on 20 subjects. Validation of platelet POC methods is time consuming and expensive but is necessary. Dave McGlasson