Monitoring of biological response to clopidogrel after treatment for non-cardioembolic ischemic stroke or transient ischemic attack

Monitoring of biological response to clopidogrel after treatment for non-cardioembolic ischemic stroke or transient ischemic attack

BACKGROUND AND PURPOSEBiological response to clopidogrel prescribed after a non-cardioembolic ischemic stroke or transient ischemic attack (TIA) has been little studied. The aim of our study (AAPIX) was to assess this response and investigate the agreement between different biological assays in reve...

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Veröffentlicht in:American journal of translational research 2019-01, Vol.11 (9), p.5332-5337
Hauptverfasser: Varvat, Jérôme, Montmartin, Aurélie, Epinat, Magali, Accassat, Sandrine, Garcin, Arnauld, Li, Guorong, Garnier, Pierre, Lambert, Claude, Mismetti, Patrick, Mallouk, Nora
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container_end_page 5337
container_issue 9
container_start_page 5332
container_title American journal of translational research
container_volume 11
creator Varvat, Jérôme
Montmartin, Aurélie
Epinat, Magali
Accassat, Sandrine
Garcin, Arnauld
Li, Guorong
Garnier, Pierre
Lambert, Claude
Mismetti, Patrick
Mallouk, Nora
description BACKGROUND AND PURPOSEBiological response to clopidogrel prescribed after a non-cardioembolic ischemic stroke or transient ischemic attack (TIA) has been little studied. The aim of our study (AAPIX) was to assess this response and investigate the agreement between different biological assays in revealing poor responders. METHODSPatients hospitalized following a non-cardioembolic ischemic stroke or transient ischemic attack (TIA) and prescribed clopidogrel were consecutively included from September 2013 to November 2015 in the Stroke Center of Saint-Etienne Hospital. Blood was drawn after 5 to 8 days of standard-dose clopidogrel. Light transmission aggregometry (LTA) and flow cytometric assays, using vasodilator-stimulated phosphoprotein [VASP] and CD62P, were accomplished for all patients. Transmission electron microscopy (TEM) was performed for a poor clopidogrel-responder and for a patient with discordant platelet assay results (platelet reactivity index (PRI) >50% and maximum platelet aggregation
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The aim of our study (AAPIX) was to assess this response and investigate the agreement between different biological assays in revealing poor responders. METHODSPatients hospitalized following a non-cardioembolic ischemic stroke or transient ischemic attack (TIA) and prescribed clopidogrel were consecutively included from September 2013 to November 2015 in the Stroke Center of Saint-Etienne Hospital. Blood was drawn after 5 to 8 days of standard-dose clopidogrel. Light transmission aggregometry (LTA) and flow cytometric assays, using vasodilator-stimulated phosphoprotein [VASP] and CD62P, were accomplished for all patients. Transmission electron microscopy (TEM) was performed for a poor clopidogrel-responder and for a patient with discordant platelet assay results (platelet reactivity index (PRI) &gt;50% and maximum platelet aggregation &lt;70%), after activation with adenosine diphosphate (ADP) 10 µM. RESULTS72 patients were included. According to LTA, VASP assay and CD62P test results, 65%, 71% and 0% of patients, respectively, had a low response to clopidogrel, indicating poor agreement between these assays. Images of ADP-activated platelet samples from a patient manifesting a low response to clopidogrel and from a patient with discordant platelet assay results showed an ultrastructural pattern typical of activation and a state of slight activation, respectively. CONCLUSIONSPlatelet function results obtained using different assays for patients having experienced a non-cardioembolic ischemic stroke or TIA were discordant. Transmission electron microscopy could be useful in certain clinical contexts when platelet function assay results disagree.</description><identifier>ISSN: 1943-8141</identifier><identifier>EISSN: 1943-8141</identifier><identifier>PMID: 31632514</identifier><language>eng</language><publisher>e-Century Publishing Corporation</publisher><subject>Review</subject><ispartof>American journal of translational research, 2019-01, Vol.11 (9), p.5332-5337</ispartof><rights>AJTR Copyright © 2019 2019</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6789282/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6789282/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,729,782,786,887,53798,53800</link.rule.ids></links><search><creatorcontrib>Varvat, Jérôme</creatorcontrib><creatorcontrib>Montmartin, Aurélie</creatorcontrib><creatorcontrib>Epinat, Magali</creatorcontrib><creatorcontrib>Accassat, Sandrine</creatorcontrib><creatorcontrib>Garcin, Arnauld</creatorcontrib><creatorcontrib>Li, Guorong</creatorcontrib><creatorcontrib>Garnier, Pierre</creatorcontrib><creatorcontrib>Lambert, Claude</creatorcontrib><creatorcontrib>Mismetti, Patrick</creatorcontrib><creatorcontrib>Mallouk, Nora</creatorcontrib><title>Monitoring of biological response to clopidogrel after treatment for non-cardioembolic ischemic stroke or transient ischemic attack</title><title>American journal of translational research</title><description>BACKGROUND AND PURPOSEBiological response to clopidogrel prescribed after a non-cardioembolic ischemic stroke or transient ischemic attack (TIA) has been little studied. The aim of our study (AAPIX) was to assess this response and investigate the agreement between different biological assays in revealing poor responders. METHODSPatients hospitalized following a non-cardioembolic ischemic stroke or transient ischemic attack (TIA) and prescribed clopidogrel were consecutively included from September 2013 to November 2015 in the Stroke Center of Saint-Etienne Hospital. Blood was drawn after 5 to 8 days of standard-dose clopidogrel. Light transmission aggregometry (LTA) and flow cytometric assays, using vasodilator-stimulated phosphoprotein [VASP] and CD62P, were accomplished for all patients. Transmission electron microscopy (TEM) was performed for a poor clopidogrel-responder and for a patient with discordant platelet assay results (platelet reactivity index (PRI) &gt;50% and maximum platelet aggregation &lt;70%), after activation with adenosine diphosphate (ADP) 10 µM. RESULTS72 patients were included. According to LTA, VASP assay and CD62P test results, 65%, 71% and 0% of patients, respectively, had a low response to clopidogrel, indicating poor agreement between these assays. Images of ADP-activated platelet samples from a patient manifesting a low response to clopidogrel and from a patient with discordant platelet assay results showed an ultrastructural pattern typical of activation and a state of slight activation, respectively. CONCLUSIONSPlatelet function results obtained using different assays for patients having experienced a non-cardioembolic ischemic stroke or TIA were discordant. Transmission electron microscopy could be useful in certain clinical contexts when platelet function assay results disagree.</description><subject>Review</subject><issn>1943-8141</issn><issn>1943-8141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNpVj01LxDAYhIso7rr6H3L0Umg-2rQXQRa_QPGi55Kkb7tx07w1yQqe_eN2cRE9zcAwDzNH2ZI2guc1FfT4j19kZzG-FUVVNhU7zRacVpyVVCyzryf0NmGwfiDYE23R4WCNciRAnNBHIAmJcTjZDocAjqg-QSApgEoj-ER6DMSjz40KnUUYNTpriI1mA-NsYgq4BYL7ivLR7iu_oUpJme15dtIrF-HioKvs9fbmZX2fPz7fPayvH_OJCZ5yWpeF0hKEKJistSmhqhn0WjaUGS17BUZwrZmQtDfGQMNqEA2nsqyY1k3HV9nVD3fa6RE6M08JyrVTsKMKny0q2_5PvN20A360laxnGJsBlwdAwPcdxNSO8xVwTnnAXWwZLyRv6lpS_g2CkXwL</recordid><startdate>20190101</startdate><enddate>20190101</enddate><creator>Varvat, Jérôme</creator><creator>Montmartin, Aurélie</creator><creator>Epinat, Magali</creator><creator>Accassat, Sandrine</creator><creator>Garcin, Arnauld</creator><creator>Li, Guorong</creator><creator>Garnier, Pierre</creator><creator>Lambert, Claude</creator><creator>Mismetti, Patrick</creator><creator>Mallouk, Nora</creator><general>e-Century Publishing Corporation</general><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190101</creationdate><title>Monitoring of biological response to clopidogrel after treatment for non-cardioembolic ischemic stroke or transient ischemic attack</title><author>Varvat, Jérôme ; Montmartin, Aurélie ; Epinat, Magali ; Accassat, Sandrine ; Garcin, Arnauld ; Li, Guorong ; Garnier, Pierre ; Lambert, Claude ; Mismetti, Patrick ; Mallouk, Nora</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p243t-1850ab7e440278bc5e682efb7912cb7faec43bb2471fccce928e49317562bb9d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Review</topic><toplevel>online_resources</toplevel><creatorcontrib>Varvat, Jérôme</creatorcontrib><creatorcontrib>Montmartin, Aurélie</creatorcontrib><creatorcontrib>Epinat, Magali</creatorcontrib><creatorcontrib>Accassat, Sandrine</creatorcontrib><creatorcontrib>Garcin, Arnauld</creatorcontrib><creatorcontrib>Li, Guorong</creatorcontrib><creatorcontrib>Garnier, Pierre</creatorcontrib><creatorcontrib>Lambert, Claude</creatorcontrib><creatorcontrib>Mismetti, Patrick</creatorcontrib><creatorcontrib>Mallouk, Nora</creatorcontrib><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of translational research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Varvat, Jérôme</au><au>Montmartin, Aurélie</au><au>Epinat, Magali</au><au>Accassat, Sandrine</au><au>Garcin, Arnauld</au><au>Li, Guorong</au><au>Garnier, Pierre</au><au>Lambert, Claude</au><au>Mismetti, Patrick</au><au>Mallouk, Nora</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Monitoring of biological response to clopidogrel after treatment for non-cardioembolic ischemic stroke or transient ischemic attack</atitle><jtitle>American journal of translational research</jtitle><date>2019-01-01</date><risdate>2019</risdate><volume>11</volume><issue>9</issue><spage>5332</spage><epage>5337</epage><pages>5332-5337</pages><issn>1943-8141</issn><eissn>1943-8141</eissn><abstract>BACKGROUND AND PURPOSEBiological response to clopidogrel prescribed after a non-cardioembolic ischemic stroke or transient ischemic attack (TIA) has been little studied. The aim of our study (AAPIX) was to assess this response and investigate the agreement between different biological assays in revealing poor responders. METHODSPatients hospitalized following a non-cardioembolic ischemic stroke or transient ischemic attack (TIA) and prescribed clopidogrel were consecutively included from September 2013 to November 2015 in the Stroke Center of Saint-Etienne Hospital. Blood was drawn after 5 to 8 days of standard-dose clopidogrel. Light transmission aggregometry (LTA) and flow cytometric assays, using vasodilator-stimulated phosphoprotein [VASP] and CD62P, were accomplished for all patients. Transmission electron microscopy (TEM) was performed for a poor clopidogrel-responder and for a patient with discordant platelet assay results (platelet reactivity index (PRI) &gt;50% and maximum platelet aggregation &lt;70%), after activation with adenosine diphosphate (ADP) 10 µM. RESULTS72 patients were included. According to LTA, VASP assay and CD62P test results, 65%, 71% and 0% of patients, respectively, had a low response to clopidogrel, indicating poor agreement between these assays. Images of ADP-activated platelet samples from a patient manifesting a low response to clopidogrel and from a patient with discordant platelet assay results showed an ultrastructural pattern typical of activation and a state of slight activation, respectively. CONCLUSIONSPlatelet function results obtained using different assays for patients having experienced a non-cardioembolic ischemic stroke or TIA were discordant. Transmission electron microscopy could be useful in certain clinical contexts when platelet function assay results disagree.</abstract><pub>e-Century Publishing Corporation</pub><pmid>31632514</pmid><tpages>6</tpages></addata></record>
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title Monitoring of biological response to clopidogrel after treatment for non-cardioembolic ischemic stroke or transient ischemic attack
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