From Dan Hood:
What testing do you recommend for Plavix effect for patients preoperatively? We have neurosurgeons testing the morning of surgery and are looking for some options.
Hi, Dan, thank you for your question. Plavix is a thienopyridine that suppresses platelet activation by blocking membrane ADP receptors. The reference method is platelet aggregometry using ADP as the agonist. I recommend Chronolog’s impedance lumiaggregometry for its simplicity and sensitivity, but light transmittance aggregometry is also acceptable.
If your laboratory is not performing aggregometry already, you may want to use one of the point-of-care instruments. Currently available and FDA-cleared are the Accumetrics VerifyNow P2Y12 and the Helena PlateletWorks ADP Kit. DiaPharma distributes theMultiplate 5.0 Analyzer, which is currently under FDA review. The Multiplate is automated and can test for aspirin, Plavix, and the glycoprotein IIb/IIIa inhibitors like abciximab simultaneously.