A comparison of platelet function tests and thromboxane metabolites to evaluate residual platelet reactivity in patients with type 2 diabetes Original article
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Abstract
Background: Type 2 diabetes (T2DM) patients are at increased risk of cardiovascular events despite long-term acetylsalicylic acid (ASA) therapy. We aimed to compare the results obtained from two major platelet function point-of-care tests and thromboxane A2 metabolites in the assessment of the prevalence of high platelet reactivity (HPR) on ASA in T2DM patients.
Methods and results: The study cohort consisted of 262 T2DM patients who had been taking ASA tablets at the dose of 75 mg per day for at least 3 months for primary or secondary prevention of myocardial infarction. Platelet reactivity analyzes were performed using VerifyNow Aspirin and PFA-100 assays. Thromboxane A2 metabolites were also measured in serum and urine to assess cyclooxygenase-1 specific platelet reactivity inhibition. The prevalence of HPR varied according to the assay used: 35,4%, for PFA-100 using epinephrine as the agonist, 16,1%, for VerifyNow Aspirin Assay, and finally, 21,6% by measuring urinary 11-dehydro-thromboxane B2 and 9,8% measuring serum throboxane B2 concentrations. HPR were found in over 55% of patients based on at least one test, and in only 2,2% based on all performed tests. Results from these tests showed poor correlation and agreement among themselves.
Conclusion: Platelet function tests are not equally effective in measuring HPR and correlate poorly among themselves.
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Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
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