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Bélanger JC, Bandeira Ferreira FL, Welman M, Boulahya R, Tanguay JF, Y.F. So D, Lordkipanidzé M. Head-to-Head Comparison of Consensus-Recommended Platelet Function Tests to Assess P2Y 12 Inhibition-Insights for Multi-Center Trials. J Clin Med 2020; 9:E332. [PMID: 31991630 PMCID: PMC7073745 DOI: 10.3390/jcm9020332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/08/2020] [Accepted: 01/12/2020] [Indexed: 11/29/2022] Open
Abstract
The vasodilator-associated stimulated phosphoprotein (VASP) phosphorylation level is a highly specific method to assess P2Y12 receptor inhibition. Traditionally, VASP phosphorylation is analyzed by flow cytometry, which is laborious and restricted to specialized laboratories. Recently, a simple ELISA kit has been commercialized. The primary objective of this study was to compare the performance of VASP assessment by ELISA and flow cytometry in relation to functional platelet aggregation testing by Multiplate® whole-blood aggregometry. Blood from 24 healthy volunteers was incubated with increasing concentration of a P2Y12 receptor inhibitor (AR-C 66096). Platelet function testing was carried out simultaneously by Multiplate® aggregometry and by VASP assessment through ELISA and flow cytometry. As expected, increasing concentrations of the P2Y12 receptor inhibitor induced a proportional inhibition of platelet aggregation and P2Y12 receptor activation across the modalities. Platelet reactivity index values of both ELISA- and flow cytometry-based VASP assessment methods correlated strongly (r = 0.87, p < 0.0001) and showed minimal bias (1.05%). Correlation with Multiplate® was slightly higher for the flow cytometry-based VASP assay (r = 0.79, p < 0.0001) than for the ELISA-based assay (r = 0.69, p < 0.0001). Intraclass correlation (ICC) was moderate for all the assays tested (ICC between 0.62 and 0.84). However, categorization into low, optimal, or high platelet reactivity based on these assays was strongly concordant (κ between 0.86 and 0.92). In conclusion, the consensus-recommended assays with their standardized cut-offs should not be used interchangeably in multi-center clinical studies but, rather, they should be standardized throughout sites.
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Affiliation(s)
- Jean-Christophe Bélanger
- Montreal Heart Institute Research Center, Montréal, QC H1T 1C8, Canada; (J.-C.B.); (F.L.B.F.); (M.W.); (R.B.); (J.-F.T.)
- Faculty of Pharmacy, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Fabio Luiz Bandeira Ferreira
- Montreal Heart Institute Research Center, Montréal, QC H1T 1C8, Canada; (J.-C.B.); (F.L.B.F.); (M.W.); (R.B.); (J.-F.T.)
- Institut Armand-Frappier Santé et Biotechnologie-INRS, Laval, QC H7V 1B7, Canada
| | - Mélanie Welman
- Montreal Heart Institute Research Center, Montréal, QC H1T 1C8, Canada; (J.-C.B.); (F.L.B.F.); (M.W.); (R.B.); (J.-F.T.)
| | - Rahma Boulahya
- Montreal Heart Institute Research Center, Montréal, QC H1T 1C8, Canada; (J.-C.B.); (F.L.B.F.); (M.W.); (R.B.); (J.-F.T.)
- Faculty of Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Jean-François Tanguay
- Montreal Heart Institute Research Center, Montréal, QC H1T 1C8, Canada; (J.-C.B.); (F.L.B.F.); (M.W.); (R.B.); (J.-F.T.)
- Faculty of Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Derek Y.F. So
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada;
| | - Marie Lordkipanidzé
- Montreal Heart Institute Research Center, Montréal, QC H1T 1C8, Canada; (J.-C.B.); (F.L.B.F.); (M.W.); (R.B.); (J.-F.T.)
- Faculty of Pharmacy, Université de Montréal, Montréal, QC H3C 3J7, Canada
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