VerifyNow

"Ticagrelor resistance, though rare, can cause severe PCI complications like acute in-stent thrombosis. VerifyNow-guided transition to prasugrel effectively mitigates risks in this case, underscoring the need for personalized antiplatelet therapy post-PCI."

"CPAL exhibits acceptable performance. It showed good correlation with AA-MA but not with the ARU of VerifyNow, which changed with slight differences in aspirin concentration. CPAL is a new platelet aggregation scoring system that may be used to monitor the effects of aspirin using an automated coagulation analyzer."

"In conclusion, the presence of CKD negatively influences the antiplatelet response to clopidogrel, but not to ticagrelor, leading to a more pronounced superiority of ticagrelor over clopidogrel in patients with CKD than in those without CKD."

This study concludes that blood samples for platelet function testing are stable for up to five hours at room temperature for the Multiplate, VerifyNow, and PFA-200 Collagen/ADP assays, allowing for a safe extension beyond current manufacturer guidelines. In contrast, the PFA-200 Collagen/EPI test showed significant deviations exceeding stability limits; however, these variations likely stem from initial cartridge-related measurement errors rather than sample degradation over time.

"Despite a reduction in neurosurgical events, CSP did not significantly improve observed platelet function in TBI patients on antiplatelet medications. Our findings highlight the disconnect between platelet function assays and clinical results and suggest transfusion of CSP versus RTP has minimal effect on platelet hemostatic function. A definitive trial is needed to assess the efficacy of differentially stored products in the bleeding patient, with consideration placed on how platelet hemostatic function is assessed."

"Assessment of platelet function using the VerifyNow assay may improve identification of residual thrombotic risk in patients with advanced atherosclerotic disease. Inclisiran appears to be a promising adjunctive therapy for dyslipidemic patients with persistently elevated cardiovascular risk and HRPR despite standard treatment. Further prospective studies are warranted to clarify the relationship between intensive LDL-C lowering, platelet reactivity, and clinical outcomes, and to optimize integrated lipid-lowering and antiplatelet strategies."

"Beyond CYP450-mediated metabolism, clopidogrel resistance is driven by immuno-vascular mechanisms involving CCL5-mediated thrombo-inflammation, CCR2-dependent monocyte recruitment, and VEGFR2-linked endothelial dysfunction. These findings advocate for precision antiplatelet strategies integrating inflammatory and angiogenic pathways to optimize therapy."

"VerifyNow-guided personalization of antiplatelet therapy is a safe and may have the potential to reduce periprocedural ischemic complications in CAS, particularly in patients with unstable plaques. Further multicenter prospective studies are needed to validate these findings and optimize individualized antiplatelet regimens."

"Therapeutic platelet inhibition was not associated with increased risk of radiographic or clinical worsening in patients with mild traumatic ICH. These findings challenge current assumptions regarding antiplatelet risk and suggest that platelet function testing may have limited utility in this setting. These findings support the need to reevaluate current guidelines and validate risk stratification approaches through prospective multicenter studies."

"The results of the current study reflect the relationship between different platelet function tests acquired through LTA and VerifyNow in a group of patients who underwent elective neurovascular procedures, with changes observed in the perioperative period in three (PRU, %inhibition, and APAL) test values, but not in 10 µM ADP MA. Furthermore, correlational analysis results indicated a stronger relationship between PRU - currently the most widely used test of antiplatelet medication effects - and APAL values than between PRU and 10 µM ADP MA. These results suggest that, in the clinical setting of the present study and based on the correlation with PRU, APAL can be a new option for monitoring antiplatelet medication effects in patients who undergo neuroendovascular procedures than 10 µM ADP MA-based monitoring, and it does so in a cost-effective manner. Individually tailored precision medicine approaches that combine patient pharmacogenetics with drug response monitoring may offer the best patient outcomes and should be the focus of future research efforts."

"This study examined the relationship between AS, endothelial dysfunction, and platelet activation by assessing specific serum biomarkers and platelet aggregation tests. We found that the coexistence of AS in patients with CAD was associated with elevated levels of the aforementioned biomarkers, which are indicative of endothelial damage and platelet activation. On the other hand, the aggregation test representing the efficacy of antiplatelet treatment was comparable between the groups, and no differences in bleeding complications were observed. The findings highlight the role of endothelial and platelet interactions in patients with CAD and AS and suggest the safety of the antiplatelet therapy in this patient population."

"Ticagrelor demonstrated superior platelet inhibition to clopidogrel in patients with PAD after revascularization. The high prevalence of clopidogrel resistance underscores the potential clinical benefit of ticagrelor for patients with PAD after revascularization."

"Clopidogrel-resistant group exhibited faster clot formation, greater clot strength, and higher platelet aggregation. Incorporating TEG into clinical practice could help identify patients at risk of inadequate clopidogrel response."

"Intravenous nitrate therapy in patients with NSTEMI delayed the onset of the antiplatelet effect of orally loaded clopidogrel by at least 4 h. This point should be kept in mind in patients using clopidogrel and nitrate therapy together."

This prospective study comparing VerifyNow, Thrombelastography (TEG), VASP, and PL-11 demonstrates that while these devices vary significantly in their detection rates of High On-treatment Platelet Reactivity (HTPR), VerifyNow is the only method that independently and robustly predicts long-term Major Adverse Cardiovascular Events (MACEs) in ACS patients. Although TEG and VASP showed higher HTPR incidences, the VerifyNow-based model provided the most superior predictive discrimination, identifying it as the most effective clinical tool among the four tested for long-term risk assessment.

"Our multi-institutional cohort confirms a high rate of Clopidogrel resistance in patients undergoing TCAR, with higher acute stent thrombosis rates noted in patients with resistance. VerifyNow P2Y12 platelet reactivity assays more reliably predict Clopidogrel resistance than TEG-PM."

"Cangrelor safely induced immediate and profound platelet inhibition [VerifyNow® and Multiplate® ADP]. We observed no significant drug-drug interaction with ticagrelor."

"PD data [light transmittance aggregometry (LTA) (20- and 5-μM adenosine diphosphate [ADP] stimuli); VerifyNow P2Y12-test; Multiplate electrode aggregometry (MEA), ADP-test] show that in contemporary real-world STEMI patients pretreated within 1 h with ticagrelor undergoing primary PCI, adding cangrelor resulted in fast and potent platelet inhibition, thus suggesting that cangrelor may bridge the gap until ticagrelor reaches its effect."

"PFTs can play a crucial role in detecting resistance and non-sensitivity to antiplatelet drugs in patients with PAD post-revascularization. However, heterogeneity of data and methods underlines the need for standardized protocols and consensus-building among PFTs. Enhancing clinical utility and reliability could help optimize antiplatelet thromboprophylaxis, minimize thrombotic complications, and improve treatment strategies in vascular surgery. Further research is necessary to solidify the role of PFTs in guiding antiplatelet therapy post-revascularization in patients with PAD."

This study compared the VerifyNow™ system, thromboelastography (TEG), and the Aggrestar PL-12 to assess their reliability in measuring platelet reactivity. While VerifyNow and TEG showed a strong correlation regarding ADP-induced reactivity, the PL-12 demonstrated only moderate consistency with the other devices. Furthermore, correlations for arachidonic acid reactivity were limited across all three platforms, suggesting they are not interchangeable. Notably, despite these variations, the PL-12 was more sensitive in identifying patients at a higher risk for stroke recurrence, highlighting that choice of device significantly impacts clinical risk stratification.

Currently, no platelet function test (PFT) perfectly monitors clopidogrel efficacy. While VerifyNow P2Y12 is the most suitable point-of-care option and ROTEM shows promise, further prospective studies are essential. An ideal assay should utilize non-anticoagulated whole blood under high shear rates to accurately reflect in vivo thrombus stability. Furthermore, while CYP2C19 testing is not recommended for guiding therapy, combining PFT with HPLC drug-level monitoring would significantly improve our understanding of patient responsiveness and clinical outcomes.

"In individuals with or without CAD, Lp(a) equal to or greater than 50 mg/dL was not associated with higher platelet reactivity [as assessed by VerifyNow™ P2Y12, Multiplate™, PFA-100, and light transmission aggregometry (LTA) assays]."