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P2Y12 inhibitors are the mainly prescribed antiplatelet drug for patients with coronary artery disease along with aspirin. Because the response of the drug was highly variable among patients, for individualized treatment VerifyNow P2Y12 assay is widely used as a point of care testing. But several clinical trials using this method did not showed clinical advantages. Several factors are pointed as the reasons, hemoglobin (Hb) level is reported as one of confounding factors.
We retrospectively analyzed the correlation between VerifyNow P2Y12 reaction unit (PRU) and hemoglobin level in 102 hemodialysis patients and compared it with 131 patients as control group from September 2009 to March 2010. And compared the PRU value with Light transmission aggregometry (LTA) value in hemodialysis patients.
The correlation was significant between Hb level and PRU value (correlation coefficient r = -0.465, p < 0.001) in hemodialysis patients. And the similar inverse correlation was observed in control group (correlation coefficient r = -0.321, p < 0.001). But LTA value did not showed correlation with Hb level (correlation coefficient r = -0.003, p = 0.979) in hemodialysis patients.
Hemoglobin level is a significant confounding factor of PRU. For evaluation of antiplatelet activity of P2Y12 inhibitors with VerifyNow P2Y12 assay in hemodialysis patients, the hemoglobin level should be considered as significant confounding factor.