Clopidogrel Platelet Function Tests

INNOVANCE PFA P2Y

December 2011

Recently a new cartridge became available in Europe for testing for the P2Y12 antagonists. This test is similar to the current PFA-100 tests in that it uses whole blood and a small sample. It does have an incubation step but the test is fairly rapid. A small correlation study has been performed with the gold standard LTA and also with VASP. It appears most useful for detection of poor responders of clopidogrel metabolism. The updated model of the instrument is called the PFA-200 and may soon be available in the U.S.

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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