A118 APAL on CN-6000 complements verifynow for multi-timepoint P2Y12 monitoring in neuroendovascular care

Le résumé fourni par la source

Background/Introduction The need for antiplatelet therapy is increasing in neuroendovascular treatments. To assess the risk of perioperative complications, we need reliable monitoring of P2Y12 inhibition. VerifyNow is common, but single-use cartridges can make repeated testing expensive. The Automated Blood Coagulation Analyzer CN-6000 allows platelet aggregation testing (APAL) in the routine coagulation lab (with PT, APTT, D-dimer). In the CN-6000 setting, the measurement cost for APAL was around tenfold lower than for a PRU test (Uematsu K et al. Ann Clin Lab Sci. 2020), making serial testing realistic. Objective/Purpose We studied whether APAL can support VerifyNow in daily practice. Methods/Case Description We reviewed 124 patients who underwent elective neuroendovascular procedure while on antiplatelet therapy. Blood was taken at four points: the day before the procedure, days 1–3 after the procedure, around 1 month, and at bleeding or thrombotic events. We compared four tests: APAL and 10 µM ADP maximum aggregation (MA) on CN-6000, PRU and % inhibition on VerifyNow. We assessed time-course changes, test correlations, and a practical APAL–PRU reference. Results/Findings PRU, % inhibition, and APAL changed significantly over time. 10 µM ADP MA changed little. Correlation with PRU was higher for APAL (r = 0.55) than for 10 µM ADP MA (r = 0.42). A practical reference showed APAL ≈ 8.3 corresponds to PRU = 240, a commonly used high on-treatment platelet reactivity threshold. Discussion/Conclusions/Learning Points For centers that use VerifyNow, measuring APAL on CN-6000 can: clarify borderline or unexpected PRU results and serve as a backup when PRU is invalid (instrument/sample error); make serial testing at key timepoints (pre-operation, days 1–3, ~1 month, event-driven) low-cost and practical; use PRU for pre-operation, with APAL available at every timepoint.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.