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01.12.2015 | Original clinical investigation | Ausgabe 1/2015 Open Access

Thrombosis Journal 1/2015

Impact of a high-fat meal on assessment of clopidogrel-induced platelet inhibition in healthy subjects

Zeitschrift:
Thrombosis Journal > Ausgabe 1/2015
Autoren:
Paul P Dobesh, Jamela F Urban, Scott W Shurmur, Julie H Oestreich
Wichtige Hinweise

Competing interests

Dr. Dobesh has served as consultant for Daiichi Sankyo, Inc. and Astra Zeneca. Dr. Shurmur has served as a speaker for Eli Lilly, Inc. and AstraZeneca.

Authors’ contributions

Concept and design: PPD, JHO. Analysis and/or interpretation of data: PPD, JFU, SWS, JHO. Critical writing or revising the intellectual content: PPD, JFU, SWS, JHO. Final approval of the version to be published: PPD, JFU, SWS, JHO.

Abstract

Background

Ideal conditions for platelet reactivity testing are critical for optimal selection of a P2Y12 inhibitor. Data are inconsistent regarding the impact of high-fat meals on test assessment.

Methods

Participants included 12 healthy subjects not taking antiplatelet drugs after a 12-hour fast. After baseline assessment, subjects were given a 600 mg dose of clopidogrel. Four hours later, maximum platelet inhibition was tested in the fasting state by light transmission aggregometry (LTA), VerifyNow P2Y12, vasodilator-stimulated phosphoprotein (VASP), and whole blood aggregometry (WBA). Subjects were then provided a high-fat meal, and platelet function was evaluated two hours later. Change in measured platelet aggregation by LTA was the primary endpoint of the study. The Wilcoxon Rank Sum test was used to compare the change in platelet reactivity between fasting and non-fasting conditions. The Spearman rho (ρ) correlation coefficient was used to evaluate the association between fasting platelet reactivity and the change following a high-fat meal.

Results

No significant change occurred in maximal light transmission, as assessed by LTA with 5 μM ADP (p = 0.15) and with 20 μM ADP (p = 0.07). There was a significant change in the area under the curve with 5 μM ADP (p = 0.03) but not with 20 μM ADP (p = 0.18). Although there was no significant change with the VerifyNow P2Y12 assay (p = 0.16), the change was correlated with the initial fasting value (Spearman’s rho p = 0.008). The VASP assay and WBA varied minimally.

Conclusion

The high-fat meal did not significantly alter platelet function assessment of commonly used platelet function tests. Greater intra-subject variability existed for the optically-dependent compared with non-optically dependent tests.

Trial registration

Literatur
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