CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

August 28th, 2013

Platelet Reactivity Testing: Do You or Don’t You?

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In the multicenter ADEPT DES study, investigators used theVerifyNow point-of-care assay (Accumetrics, San Diego, CA, USA) to assess platelet reactivity (by P2Y12 reaction units; PRU) in patients after successful PCI. The investigators found that high platelet reactivity in patients on clopidogrel was not an independent predictor of mortality, and that PRU did not provide utility beyond baseline risk profile in assessing the patients’ propensity for death.

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  • Why or why not?
  • If you do, how do you use that information?
  • Will the ADEPT DES study affect your use of platelet reactivity testing?

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2 Responses to “Platelet Reactivity Testing: Do You or Don’t You?”

  1. Enrique Guadiana, Cardiology says:
    August 28, 2013 at 12:13 pm

    For the moment the use of antiplatelet function testing to tailor therapy does not seem appropriate and in consecuence there is no routine role for platelet function testing at the present time.

    If I am concern with patelet reactivity I will use a newer agents, prasugrel, ticagrelor, and cangrelor, they are more rapid, complete, less variable effects on platelet function than clopidogrel especially prasugel in the context of avoiding stent thrombosis.

  2. Fahim H Jafary, MD, FACC, FSCAI says:
    September 1, 2013 at 7:39 pm

    We don’t. That said, I wouldn’t go so far as to say it’s ‘useless’ because in some patients I can see a potential value for it’s NEGATIVE predictive value (ie, if platelets reactive on clopidogrel long term outlook is very good). The obvious problem is the very poor PPV in those who are ‘non-reactive’.