VerifyNowを用いたP2Y12受容体拮抗薬による血小板凝集抑制効果の検討：ヘモグロビン値を考慮したパス図解析 (第137回成医会総会一般演題)

概要

Background
　VerifyNow P2Y12 is commonly used to examine the effects of P2Y12 inhibitors on platelet function. On the contrary, it is also known that this test is greatly influenced by several factors including hemoglobin value. Therefore, re-evaluation of the effects of P2Y12 receptor antagonists is required. The aim of this study is to investigate the effects of Prasugrel and Clopidogrel using VerifyNow P2Y12 excluding other factors and confounding bias.
　
Methods
　In total, 407 subjects were included, 185taking Prasugrel and 222 taking Clopidogrel. The study was conducted using structure equation modeling. The factor affecting the P2Y12 reaction unit (PRU) was incorporated into one equation, and the analysis was made by devising the path diagram considering the elimination of confounding property.

Results
　Hemoglobin values and platelet count had a negative relationship with PRU. Prasugrel lowered PRU more than Clopidogrel did. Proton pump inhibitor (PPI) intake and female sex correlated with increased PRU. No significance was found in this analysis with regard to other factors, i.e., age, body mass index, glucose level, HbA1c, and current smoking.
　
Conclusions
　The absolute value of PRU is influenced by hemoglobin value, platelet count, sex, and PPI. However, the PRU-lowering effect of Prasugrel is remarkable, even in addition to that. The impact of other factors on PRU was not clear in this analysis.