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Comparison of acetylsalicylic acid and clopidogrel non-responsiveness assessed by light transmittance aggregometry and PFA-100® in patients undergoing neuroendovascular procedures

  • Christina C. Rolling ORCID logo EMAIL logo , Julia Tomada , Andreas M. Frölich , Brigitte Holst , Katharina Holstein , Minna Voigtländer , Snjezana Janjetovic , Munif Haddad , Thomas Renné , Jens Fiehler , Carsten Bokemeyer , Thierry Rolling and Florian Langer
Published/Copyright: August 31, 2020
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 59 Issue 2

Abstract

Objectives

Dual platelet inhibition is commonly used for prevention of cardiovascular events in patients undergoing neuroendovascular procedures. Non-responsiveness to platelet inhibitors may be associated with adverse outcomes. The aim of this study was to evaluate the reliability of the platelet function analyzer PFA-100® in comparison to light transmittance aggregometry (LTA) for monitoring clopidogrel and acetylsalicylic acid (ASA) non-responsiveness in a cohort of patients treated for intracranial aneurysm or cranial artery stenosis.

Methods

Non-responsiveness to clopidogrel and ASA was assessed by LTA using adenosine diphosphate (ADP) and arachidonic acid and by PFA-100® with the ADP/prostaglandin E1 (PGE1) and collagen/epinephrine cartridges, respectively.

Results

A total of 203 patients (145 females; median age, 57 years) were analyzed. Agreement between the two tests was poor for clopidogrel non-responsiveness (ƙ=0.19) and not better than chance for ASA non-responsiveness (ƙ=0.01). Clopidogrel non-responsiveness by LTA and PFA-100® was associated with higher von Willebrand factor antigen and activity levels. ADP-induced platelet disaggregation was lower in patients with clopidogrel non-responsiveness as assessed by PFA-100®. Clopidogrel non-responsiveness by LTA was associated with a higher prevalence of diabetes and a higher body mass index (BMI). Adverse outcomes (death, thromboembolism, or in-stent thrombosis) occurred in 13% (n=26) of all patients independently of ASA and clopidogrel non-responsiveness as assessed by both devices.

Conclusions

Our results show that LTA and PFA-100® are not interchangeable in the assessment of ASA and clopidogrel non-responsiveness in patients undergoing neuroendovascular interventions.

Keywords: acetylsalicylic acid non-responsiveness; clopidogrel non-responsiveness; light transmittance aggregometry; neuroendovascular procedures; PFA-100®
Corresponding author: Christina C. Rolling, Department of Oncology/Hematology and BMT with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany, E-mail:

  1. Research funding: None declared.

  2. Author contributions: Christina C. Rolling and Florian Langer: conceived and designed the study, analyzed the data and wrote the first draft of the manuscript; Thierry Rolling: analyzed the data and edited the manuscript; Munif Haddad and Thomas Renné: provided laboratory data and edited the manuscript; Andreas Frölich, Brigitte Holst and Jens Fiehler: performed image data analyses and edited the manuscript. All remaining authors (Julia Tomada, Katharina Holstein, Minna Voigtländer, Snjezana Janjetovic and Carsten Bokemeyer) contributed to patient data and edited the manuscript. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Ethical approval: The study was reviewed by the Hamburg Medical Council’s Ethics Committee (PV 7113).

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Received: 2020-05-15
Accepted: 2020-08-03
Published Online: 2020-08-31
Published in Print: 2021-02-23

© 2020 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2020-0737
Keywords for this article
acetylsalicylic acid non-responsiveness; clopidogrel non-responsiveness; light transmittance aggregometry; neuroendovascular procedures; PFA-100®

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Assuring the quality of examinations using faecal immunochemical tests for haemoglobin (FIT)
  4. Review
  5. Capillary electrophoresis based on nucleic acid analysis for diagnosing inherited diseases
  6. Mini Reviews
  7. Negative hair test result after long-term drug use. About a case involving morphine and literature review
  8. Prorenin and active renin levels in paediatrics: a bioanalytical review
  9. Opinion Paper
  10. From therapeutic drug monitoring to total drug monitoring and drug-omics
  11. Perspectives
  12. The internal quality control in the traceability era
  13. Genetics and Molecular Diagnostics
  14. External quality assessment (EQA) and alternative assessment procedures (AAPs) in molecular diagnostics: findings of an international survey
  15. General Clinical Chemistry and Laboratory Medicine
  16. An evaluation of ten external quality assurance scheme (EQAS) materials for the faecal immunochemical test (FIT) for haemoglobin
  17. Optimizing hepcidin measurement with a proficiency test framework and standardization improvement
  18. Development of a certified reference material for anti-β2-glycoprotein I IgG – commutability studies
  19. Influence of patients’ clinical features at intensive care unit admission on performance of cell cycle arrest biomarkers in predicting acute kidney injury
  20. Efficacy of weekly administration of cholecalciferol on parathyroid hormone in stable kidney-transplanted patients with CKD stage 1–3
  21. Plasma metanephrines and prospective prediction of tumor location, size and mutation type in patients with pheochromocytoma and paraganglioma
  22. Emicizumab, the factor VIII mimetic bi-specific monoclonal antibody and its measurement in plasma
  23. Reference Values and Biological Variations
  24. Age appropriate reference intervals for eight kidney function and injury markers in infants, children and adolescents
  25. Cardiovascular Diseases
  26. Comparison of acetylsalicylic acid and clopidogrel non-responsiveness assessed by light transmittance aggregometry and PFA-100® in patients undergoing neuroendovascular procedures
  27. Trimethylamine-N-oxide (TMAO) predicts short- and long-term mortality and poor neurological outcome in out-of-hospital cardiac arrest patients
  28. Non-lactate strong ion difference and cardiovascular, cancer and all-cause mortality
  29. Infectious Diseases
  30. Performance of three automated SARS-CoV-2 antibody assays and relevance of orthogonal testing algorithms
  31. Development, evaluation, and validation of machine learning models for COVID-19 detection based on routine blood tests
  32. Searching for a role of procalcitonin determination in COVID-19: a study on a selected cohort of hospitalized patients
  33. Association of kidney function with effectiveness of procalcitonin-guided antibiotic treatment: a patient-level meta-analysis from randomized controlled trials
  34. Erratum
  35. Corrigendum to: The role of hyperhomocysteinemia as well as folate, vitamin B6 and B12 deficiencies in osteoporosis – a systematic review
  36. Letter to the Editors
  37. Harmonization of antineutrophil cytoplasmic antibodies (ANCA) testing by reporting test result-specific likelihood ratios: position paper
  38. Independent internal quality control (IQC) for faecal immunochemical tests (FIT) for haemoglobin: use of FIT manufacturers’ IQC for other FIT systems
  39. Parallel testing of 241 clinical nasopharyngeal swabs for the detection of SARS-CoV-2 virus on the Cepheid Xpert Xpress SARS-CoV-2 and the Roche cobas SARS-CoV-2 assays
  40. Sustained SARS-CoV-2 nucleocapsid antibody levels in nonsevere COVID-19: a population-based study
  41. Evidence for increased circulating procoagulant phospholipids in patients with COVID-19 pneumonia and their prognostic role
  42. Complete blood counts and cell population data from Sysmex XN analyser in the detection of SARS-CoV-2 infection
  43. Macro creatine kinase in an asymptomatic patient: a case report
  44. Implementation of pre-labelled barcode tubes and the GeT-System in a general hospital for the exact documentation of the time of venous blood sample and improvement of sample quality
  45. Determination of free light chains: assay-dependent differences in interpretation
  46. Association between SOX17, Wif-1 and RASSF1A promoter methylation status and response to chemotherapy in patients with metastatic gastric cancer
  47. Effect of two organizational interventions on the frequency of haemoglobin A1c and erythrocyte sedimentation rate testing
  48. Haemoglobin A1c determination from dried blood spots prepared with HemaSpot™ blood collection devices: comparison with fresh capillary blood
  49. Stability of catecholamines in whole blood: influence of time between collection and centrifugation
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