Ann Lab Med 2018; 38(5): 413-419  https://doi.org/10.3343/alm.2018.38.5.413
Platelet Function Analyzer-200 P2Y Results Are Predictive of the Risk of Major Adverse Cardiac Events in Korean Patients Receiving Clopidogrel Therapy Following Acute Coronary Syndrome
Hyeon-Ho Lim, M.D.1, Shuhua Li, M.D.2, Gyu-Dae An, M.D.1, Kwang-Sook Woo, M.D.1, Kyeong-Hee Kim, M.D.1, Jeong-Man Kim, M.D.1, Moo-Hyun Kim, M.D.3, and Jin-Yeong Han, M.D.1
Department of Laboratory Medicine1, Dong-A University College of Medicine, Busan, Korea; Department of Nephrology2, Heilongjiang Academy of Traditional Chinese Medicine, Harbin, China; Department of Cardiology3, Dong-A University College of Medicine, Busan, Korea
Corresponding author: Jin-Yeong Han
https://orcid.org/0000-0003-0280-2739
Department of Laboratory Medicine, Dong-A University College of Medicine, 26 Daesingongwon-ro, Seo-gu, Busan 49201, Korea
Tel: +82-51-240-5323
Fax: +82-51-255-9366
E-mail: jyhan@dau.ac.kr
Received: June 27, 2017; Revised: January 10, 2018; Accepted: May 3, 2018; Published online: September 1, 2018.
© Korean Society for Laboratory Medicine. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Clopidogrel is one of the most commonly used anti-platelet agents in cardiovascular diseases. We analyzed the relationship between the platelet function analyzer (PFA)-200 P2Y (INNOVANCE PFA-200 System, Siemens Healthcare, Germany) results and occurrence of major adverse cardiac events (MACEs) in Korean patients with recent-onset acute coronary syndrome (ACS) taking clopidogrel.
Methods: Between August 2013 and June 2016, we prospectively enrolled 106 patients with recent-onset ACS who had been treated with clopidogrel. We obtained blood samples and measured closure time (CT) using the PFA-200 P2Y test. Patients were divided into two groups on the basis of a CT cut-off value of 106 seconds. We compared patient characteristics and various MACEs that occurred during the follow-up period.
Results: The CTs for 78 patients exceeded the cut-off value. At the time of these analyses, 11 patients had been diagnosed with MACEs. In the time-to-event analysis, there was a difference between the two groups (P<0.001). After adjusting other variables associated with MACE occurrence, CT value was the strongest predictor of MACEs, with a 7.30-fold occurrence risk (P=0.002).
Conclusions: We found a strong relationship between CT and MACE risk in Korean patients with recent-onset ACS taking clopidogrel. Accordingly, PFA-200 P2Y results could be used as a predictive marker for MACE risk in such patients.
Keywords: PFA-200 P2Y test, Clopidogrel, Major adverse cardiac events



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