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Detection of individual responses to clopidogrel: validation of a novel, rapid analysis using TEG 6s

Detection of individual responses to clopidogrel: validation of a novel, rapid analysis using TEG 6s
Detection of individual responses to clopidogrel: validation of a novel, rapid analysis using TEG 6s
Introduction There is potential value in testing individual response to P2Y12 inhibitors in order to predict ischaemic and bleeding risk in patients undergoing percutaneous coronary intervention. The aims of this study were:(a) to validate the ability of a novel point of care(POC) assay, TEG 6s, to detect changes in ADP-induced whole blood clotting in volunteers and patients given clopidogrel using TEG 5000 as a reference and (b) to compare a novel, rapid parameter, area under the curve at 15 minutes(AUC15), with the traditional maximum clot amplitude (MA) in TEG 6s. Methods 25 participants were included in whom ADP-induced clotting was measured at 4 time points:a) 12 healthy volunteers given 600mg of clopidogrel;b) 12 patients with ACS given 600mg of clopidogrel c) 1 healthy volunteer given 600mg of clopidogrel on 5 separate occasions. All samples were tested using conventional TEG 5000 and the new point of care TEG 6S, and a new parameter called AUC15 was compared with MA in TEG6s. Results 1.TEG 5000 and TEG 6s both detected changes in ADP-induced platelet activation. Bland Altman analysis demonstrated a good level of agreement between them. 2.For TEG 6S, correlation between MA and the novel AUC15 was strong for both thrombin and ADP channels (R2=0.867, R=0.936, p<0.001), and the AUC15 result was available on average 13.3 mins earlier. Conclusions TEG 6s is a rapid, easy to use and accurate test of ADP-induced clotting using TEG 5000 as a reference. A novel parameter, AUC15, is a viable, time-saving option for this test and has potential value in personalised P2Y12 inhibitor therapy
1755-5914
1-25
Olechowski, Bartosz
b025b40b-f9fa-4b8e-8f57-310d47e57700
Dalton, Richard T.
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Khanna, Vikram
17b557ad-b071-4d1a-84dd-3ba58470cee0
Ashby, Alexander
f403fd28-7991-4d70-96c5-9dccdf339e32
Vavyla, Maria
b6e562a5-a052-4a3c-950e-52d1b66c6a8b
Mariathas, Mark
e8dbbe0d-d303-41a4-a5a2-fa8900accfe6
Harris, Scott
19ea097b-df15-4f0f-be19-8ac42c190028
Nicholas, Zoe
98403583-c418-45ad-836b-1831517dcc5f
Mahmoudi, Michael
f6a55246-399e-4f81-944e-a4b169786e8a
Curzen, Nick
70f3ea49-51b1-418f-8e56-8210aef1abf4
Olechowski, Bartosz
b025b40b-f9fa-4b8e-8f57-310d47e57700
Dalton, Richard T.
22502b2a-837e-44b0-ab88-17804a1cb995
Khanna, Vikram
17b557ad-b071-4d1a-84dd-3ba58470cee0
Ashby, Alexander
f403fd28-7991-4d70-96c5-9dccdf339e32
Vavyla, Maria
b6e562a5-a052-4a3c-950e-52d1b66c6a8b
Mariathas, Mark
e8dbbe0d-d303-41a4-a5a2-fa8900accfe6
Harris, Scott
19ea097b-df15-4f0f-be19-8ac42c190028
Nicholas, Zoe
98403583-c418-45ad-836b-1831517dcc5f
Mahmoudi, Michael
f6a55246-399e-4f81-944e-a4b169786e8a
Curzen, Nick
70f3ea49-51b1-418f-8e56-8210aef1abf4

Olechowski, Bartosz, Dalton, Richard T., Khanna, Vikram, Ashby, Alexander, Vavyla, Maria, Mariathas, Mark, Harris, Scott, Nicholas, Zoe, Mahmoudi, Michael and Curzen, Nick (2018) Detection of individual responses to clopidogrel: validation of a novel, rapid analysis using TEG 6s. Cardiovascular therapeutics, 1-25, [e12433]. (doi:10.1111/1755-5922.12433).

Record type: Article

Abstract

Introduction There is potential value in testing individual response to P2Y12 inhibitors in order to predict ischaemic and bleeding risk in patients undergoing percutaneous coronary intervention. The aims of this study were:(a) to validate the ability of a novel point of care(POC) assay, TEG 6s, to detect changes in ADP-induced whole blood clotting in volunteers and patients given clopidogrel using TEG 5000 as a reference and (b) to compare a novel, rapid parameter, area under the curve at 15 minutes(AUC15), with the traditional maximum clot amplitude (MA) in TEG 6s. Methods 25 participants were included in whom ADP-induced clotting was measured at 4 time points:a) 12 healthy volunteers given 600mg of clopidogrel;b) 12 patients with ACS given 600mg of clopidogrel c) 1 healthy volunteer given 600mg of clopidogrel on 5 separate occasions. All samples were tested using conventional TEG 5000 and the new point of care TEG 6S, and a new parameter called AUC15 was compared with MA in TEG6s. Results 1.TEG 5000 and TEG 6s both detected changes in ADP-induced platelet activation. Bland Altman analysis demonstrated a good level of agreement between them. 2.For TEG 6S, correlation between MA and the novel AUC15 was strong for both thrombin and ADP channels (R2=0.867, R=0.936, p<0.001), and the AUC15 result was available on average 13.3 mins earlier. Conclusions TEG 6s is a rapid, easy to use and accurate test of ADP-induced clotting using TEG 5000 as a reference. A novel parameter, AUC15, is a viable, time-saving option for this test and has potential value in personalised P2Y12 inhibitor therapy

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Olechowski_et_al-2018-Cardiovascular_Therapeutics - Accepted Manuscript
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Accepted/In Press date: 9 April 2018
e-pub ahead of print date: 22 April 2018
Published date: August 2018

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Local EPrints ID: 420945
URI: http://eprints.soton.ac.uk/id/eprint/420945
ISSN: 1755-5914
PURE UUID: ffd8ded3-9031-4de2-9a97-ed1a737d4c9c
ORCID for Michael Mahmoudi: ORCID iD orcid.org/0000-0003-1293-8461

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Date deposited: 18 May 2018 16:30
Last modified: 17 Dec 2019 05:27

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Author: Bartosz Olechowski
Author: Richard T. Dalton
Author: Vikram Khanna
Author: Alexander Ashby
Author: Maria Vavyla
Author: Mark Mariathas
Author: Scott Harris
Author: Zoe Nicholas
Author: Nick Curzen

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