Clopidogrel Platelet Function Tests

Platelet Aggregation (Cont'd)

December 2011

LTA uses multiple agonists to stimulate platelet aggregation and the timing, slope and percent of maximum aggregation are reviewed by a pathologist in interpreting the results.

The blood specimen cannot be collected at an offsite facility and shipped to the testing site, due to nonspecific activation of platelets. The testing is usually only performed during limited hours on dayshift in a special coagulation laboratory using highly skilled personnel.

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Platelet Aggregation (Cont'd)

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Jump to section:

• Introduction
• Learning Objectives
• Platelet Function Tests for the Detection of Clopidogrel Resistance¹
• Platelet Function Tests for the Detection of Clopidogrel Resistance
• Caveat: There Is No Perfect Platelet Function Test...
• Problems With Testing For Clopidogrel
• How We Choose a Testing Method
• Methodology Table
• Platelet Function Testing Available at Mayo Clinic Florida
• Light Transmission Platelet Aggregometry Studies (LTA)
• Platelet Aggregation (Cont'd)
• Normal Patient
• Accumetrics VerifyNow Test
• VerifyNow P2Y₁₂ Test
• P2Y₁₂ Test Interferences
• P2Y₁₂ Antagonists²
• Can These Platelet Function Tests Be Used for Ticagrelor (Brilinta/Brilique)?
• PFA-100
• PFA–100 (Cont'd)
• INNOVANCE PFA P2Y
• TEG — Platelet Mapping
• Results of VerifyNow Testing
• 2009–2011 Clopidogrel Response at 30%
• Genetic Testing: Clopidogrel Metabolism
• Clopidogrel Metabolism
• Number of Gene Polymorphisms
• Clopidogrel Metabolism and Genetic Polymorphisms
• Why Do Genetic Testing?
• Clopidogrel Genetics (Cont'd)
• Caveats — Other Reasons for Poor Response to Clopidogrel
• CYP2C19 Polymorphism May Require Another Factor
• Controversy for Clopidogrel
• Warning: Diminished Effectiveness In Poor Metabolizers
• What Does Warning Mean For Clinicians With Patients On Clopidogrel?
• FDA Answer
• More Questions
• Summary
• References
• Questions?
• Disclosure