The Study Of The PFA P2Y Assay In Monitoring Clopidogrel Therapy

Objective ?To explore the new platelet function test PFA P2Y (tested with PFA-200) in monitoring the efficacy of clopidogrel therapy in elderly patients with cardiovascular disease. ?To explore the new platelet function test PFA P2Y (tested with PFA-200) in monitoring the value of clopidogrel therapy in patients after PCI.Methods ?Fifty-six elderly patients who received clopidogrel therapy in the Department of Cardiology of PLA General Hospital from March to August in 2016 were selected and 85 healthy volunteers were recruited. All the subjects underwent PFA P2Y, LTA (light transmittance aggregometry) and TEG (Thromboelastograph) tests. Spearman correlation coefficients were used to test associations between different methods. Agreement among the three platelet function methods was assessed using Cohen's kappa coefficient. ? A total of 37 patients with dual antiplatelet (aspirin and clopidogrel) therapy were enrolled in the Intraocular Nursing Unit of PLA General Hospital from September 2016 to April 2017,and 85 healthy volunteers were recruited. PFA P2Y and TEG were used to monitor all platelet Functions. Spearman correlation coefficient was used to test association between the two methods. Agreement between the two methods was assessed using Cohen's kappa coefficient.Results ? PFA P2Y, LTA and TEG showed that the results of platelet function in elderly patients with cardiovascular disease were significantly different from that of healthy subjects (P <0.001). Correlations between methods were PFA P2Y vs. LTA(r=-0.701,P<0.001), PFA P2Y vs. TEG(r=0.475,P<0.001). The agreement between PFA P2Y and LTA was 75% and that of PFA P2Y and TEG was 67.9%. The ? statistics between PFA P2Y and LTA was 0.434 (P=0.001) and that of PFA P2Y and TEG was 0.242 (P=0.046).Based on the ADP-induced maximum platelet aggregation rate of LTA >50% as the laboratory clopidogrel resistance, the cut-off of PFA P2Y was 119s (AUC 0.733,sensitivity 75.6%,specificity 73.3%).? PFA P2Y and TEG showed that the platelet function of patients treated with dual antiplatelet (aspirin and clopidogrel) therapy was statistically different from that of healthy subjects (P <0.001). Correlation between PFA P2Y and TEG was 0.588(P<0.001). The agreement between PFA P2Y and TEG was 70.3%. The ? statistics between PFA P2Y and TEG was 0.351 (P=0.012).Conclusion ? PFA P2Y has a moderate correlation and agreement with LTA, but has a poor correlation and agreement with TEG. PFA P2Y could be a useful tool for the assessment of clopidogrel effects in elderly patients with cardiovascular disease and the cut-off value 119s should be confirmed in further study associated with long-term clinical ischemic events. ? PFA P2Y has a moderate agreetment and correlation with TEG in the monitoring of clopidogrel therapy in patients after PCI, PFA P2Y could be a useful tool to monitor clopidogrel therapy after PCI.