The Ultegra rapid platelet function assay: Comparison to standard platelet function assays in patients undergoing percutaneous coronary intervention with abciximab therapy

Guy L. Wheeler, Gregory A. Braden, Steven R. Steinhubl, Dean J. Kereiakes, Kandice Kottke-Marchant, Alan D. Michelson, Mark I. Furman, Michele N. Mueller, David J. Moliterno, David C. Sane

Research output: Contribution to journalArticlepeer-review

59 Scopus citations

Abstract

Background: Despite the proven benefit of glycoprotein IIb/IIIa inhibitors during percutaneous coronary intervention, significant interpatient variability exists in antiplatelet response. Furthermore, a diminished degree of platelet inhibition is an independent predictor of adverse cardiac events, highlighting the need for accurate and precise monitoring of platelet function. Methods: Patients (n = 192) who underwent elective percutaneous coronary intervention at 4 centers were enrolled. The following 3 time points were studied: 1, baseline, before abciximab bolus administration; 2, during, within 1 hour of abciximab bolus administration; and 3, post, 24 hours after abciximab bolus administration or at the time of patient discharge, whichever occurred first. The following 3 assays were compared at all time points: Ultegra rapid platelet-function assay (Ultegra RPFA), conventional turbidometric platelet aggregometry, and receptor binding assay with [125I]-abciximab. Variability in Ultegra RPFA measurements between operators was determined with performance of the assays at the point of care and in the laboratory. A sub-study of 22 patients at 1 center was performed in which the laboratory scientist performed all 3 assays in duplicate at each time point. Results: Comparison with the receptor binding assay and conventional platelet aggregometry in 120 patients showed that the Ultegra RPFA correlated with aggregometry (r = 0.89) and with the receptor binding assay (r = 0.89). There was good agreement (r = 0.80) between values obtained by intended users and those obtained by laboratory scientists. Furthermore, Ultegra RPFA values had equivalent precision to the standard assays. Conclusion: The Ultegra RPFA has equivalent accuracy and precision when compared with the 2 reference assays studied. Ultegra RPFA measurements are not operator-dependent and are not influenced by concomitant medications, hematologic parameters, or demographics.

Original languageEnglish
Pages (from-to)602-611
Number of pages10
JournalAmerican Heart Journal
Volume143
Issue number4
DOIs
StatePublished - 2002

Bibliographical note

Funding Information:
From the aWake Forest University School of Medicine; bWilford Hall Medical Center; cThe Lindner Center and Ohio Heart Health Center; dThe Cleveland Clinic Foundation; and the eUniversity of Massachusetts Medical School. This study was funded in part by Accumetrics, Inc, San Diego, Calif. Submitted April 27, 2001; accepted November 12, 2001. Reprint requests: David C. Sane, MD, Associate Professor of Internal Medicine, Section of Cardiology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157-1045. E-mail: dsane@wfubmc.edu Copyright 2002, Mosby, Inc. All rights reserved. 0002-8703/2002/$35.00 + 0 4/1/121734 doi:10.1067/mhj.2002.121734

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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