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Predicting ischaemic events using platelet reactivity in patients receiving clopidogrel: Indirect meta‐comparison among VerifyNow, light transmission aggregometry and thromboelastography
Author(s) -
Xiang Qian,
Wang Zhe,
Zhang HanXu,
Liu ZhiYan,
Xie QiuFen,
Hu Kun,
Mu GuangYan,
Ma LingYue,
Zhang Zhuo,
Jiang Jie,
Cui YiMin
Publication year - 2020
Publication title -
basic and clinical pharmacology and toxicology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.805
H-Index - 90
eISSN - 1742-7843
pISSN - 1742-7835
DOI - 10.1111/bcpt.13429
Subject(s) - medicine , thromboelastography , prospective cohort study , clopidogrel , receiver operating characteristic , odds ratio , area under the curve , incidence (geometry) , thrombelastography , myocardial infarction , platelet , physics , optics
The present study compared performances of the three major methods used for assessing platelet reactivity (PR)—VerifyNow, light transmission aggregometry (LTA) and thromboelastography (TEG)—to predict ischaemic events in patients receiving clopidogrel. PubMed, EMBASE and the Cochrane Library were searched from their inception to April 2019 for prospective studies that examined PR using VerifyNow, LTA or TEG and the incidence of ischaemic events. The investigated diagnostic indices include sensitivity, specificity, positive (PLR) and negative likelihood ratio (NLR), diagnostic odds ratio and area under the receiver operating characteristic curves (AUC) of VerifyNow, LTA and TEG, respectively. A total of 26 prospective studies involving 22 185 patients were included in the analysis. The pooled AUC was 0.71 (95% CI: 0.67‐0.75) for VerifyNow, 0.60 (95% CI: 0.55‐0.64) for LTA and 0.81 (95% CI: 0.77‐0.84) for TEG. Results of indirect comparisons indicated the AUC of VerifyNow was higher than that of LTA (1.18, 95% CI: 1.08‐1.30) and lower than that of TEG (0.88, 95% CI: 0.82‐0.94). TEG outperformed the other two methods for assessing PR in all predictive measures, including sensitivity, specificity, PLR and NLR. Despite a lack of studies that directly compared the three methods, our findings suggest that TEG should be recommended.