Effectiveness of Platelet Function Analyzer-100 for Laboratory Detection of Anti-Platelet Drug-Induced Platelet Dysfunction
- Authors
- Kweon, Oh Joo; Lim, Yong Kwan; Kim, Bohyun; Lee, Mi-Kyung; Kim, Hye Ryoun
- Issue Date
- Jan-2019
- Publisher
- 대한진단검사의학회
- Keywords
- Platelet Function Analyzer-100; Aspirin; Clopidogrel; Non-steroidal anti-inflammatory drugs; High on-treatment platelet reactivity
- Citation
- Annals of Laboratory Medicine, v.39, no.1, pp 23 - 30
- Pages
- 8
- Journal Title
- Annals of Laboratory Medicine
- Volume
- 39
- Number
- 1
- Start Page
- 23
- End Page
- 30
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/4846
- DOI
- 10.3343/alm.2019.39.1.23
- ISSN
- 2234-3806
2234-3814
- Abstract
- Background: High on-treatment platelet reactivity (HTPR) is the phenomenon wherein patients exhibit normal platelet activity in laboratory testing despite adequate adherence to anti-platelet treatment. We investigated the detection rates of Platelet Function Analyzer (PFA)-100 (Dade Behring AG, Dudingen, Switzerland) for drug-induced platelet dysfunction and analyzed potential contributors to HTPR with practical PFA-100 data over six years. Methods: We used data from 6,957 patients who underwent PFA-100 testing after receiving aspirin, clopidogrel, or non-steroidal anti-inflammatory drugs (NSAIDs). Of these, 6,163 patients were tested with only the collagen/epinephrine cartridge (Col/EPI) of PFA-100; 794 were tested with both Col/EPI and the collagen/ADP cartridge (Col/ADP). We calculated PFA-100 closure time (CT) for each drug and compared the clinical and laboratory characteristics of the patients with prolonged CTs and normal CTs (i.e., HTPR). Results: In Col/EPI, 73.2% (365/499), 72.6% (390/537), and 55.3% (3,442/6,228) patients showed prolonged CTs for aspirin, clopidogrel, and NSAIDs, respectively. In Col/ADP, prolonged CTs were observed in 37.4% (34/91), 43.2% (35/81), and 29.6% (200/676) of patients receiving aspirin, clopidogrel, and NSAIDs, respectively. Of the patients tested with both cartridges, 88.9% (48/54), 95.3% (41/43), and 89.0% (577/648) of the patients receiving aspirin, clopidogrel, and NSAIDs had prolonged CTs, and 10.0% (79/794) showed normal CTs regardless of drugs. For clopidogrel users (both cartridges), there were more patients with malignancies in the normal CT than prolonged CT group. Conclusions: PFA-100 is not sufficiently effective for laboratory screening of drug-induced platelet dysfunction. Malignancy may contribute to clopidogrel-related HTPR in PFA-100.
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