VerifyNow Platelet Inhibition

General Information

Lab Name

Lab Code

VERPLT

Epic Ordering

VerifyNow Platelet Inhibition

Description

Results could be affected by the following: GPIIb/IIIa inhibitors, low HCT, low PLT or inherited platelet disorders. Patients with HCT<20% or PLT<50 K/uL cannot be tested with the VerifyNow Assay. Samples should be collected 2 to 30 hours after ingestion of aspirin to show drug effect. Suggested timing for testing patients on P2Y12 inhibitory drugs is dependent on dosage given.

VerifyNow P2Y12 Suggested Sample Draw Time:

Medications Tested	Dose Given	Suggested Sample Draw Time
Clopidogrel (Plavix)	75 mg	7 days on maintenance
Clopidogrel (Plavix)	300 mg	8 hours post bolus
Clopidogrel (Plavix)	600 mg	6 hours post bolus
Prasugrel (Effient)	5 mg	5 days on maintenance
Prasugrel (Effient)	10 mg	5 days on maintenance
Prasugrel (Effient)	60 mg	45 minutes post bolus
Ticagrelor (Brilinta)	90 mg (bid)	1 day on maintenance (within 8 hours of last dose for maximal effect)
Ticagrelor (Brilinta)	180 mg	2 hours post bolus (within 8 hours for maximal effect)

Do not test patients who have taken a GP llb/llla inhibitor tirofiban (Aggrastat®) or eptifibatide (Integrilin®) within two days, or abciximab (ReoPro®) within two weeks. Depending on the amount of GP IIb/IIIa inhibitor present in the sample, P2Y12 results may be markedly shortened or Error/Attention code may be displayed.

Synonyms

ASA resistance, aspirin resistance, clopidogrel, Effient, Efient, Plavix, Prasugrel, Ticlid, ticolpidine, Verify Now, VerifyNow PRU

Components

Code	Name
VERASG	VerifyNow Aspirin Assay Group
VERASP	VerifyNow Aspirin Assay
VERP2Y	VerifyNow P2Y12 Assay
P2Y12	VerifyNow P2Y12 Reaction

Interpretation

Method: VerifyNow System
Reference Range: See individual components
Ref. Range Notes: Expected range for patient not on P2Y12 inhibitory drug is 182-335 PRU. This test is not to be used for therapeutic monitoring. Please see General Information section on the VERP2Y test for proper usage of this assay. For more information about the VerifyNow System see: http://www.instrumentationlaboratory.com/us/en/verifynow-system.

P2Y12 Reaction Units (PRU) report the amount of P2Y12 receptor-mediated aggregation. Units are calculated as a function of the rate and extent of platelet aggregation in the ADP channel of the assay.

Ordering & Collection

Specimen Type: Blood
Collection: Peripheral draw recommended. Special collection tubes required. Call HMC Laboratory at 206-744-3451 to obtain Greiner citrate tubes.

Draw 2 mL blood into each of the three Greiner citrate tubes (must fill to the proper level).
Handling Instructions: Sample handling is critical for this assay. Carry specimen to laboratory at room temperature within 3 hours of collection.

DO NOT SEND SAMPLES IN PNEUMATIC TUBE SYSTEM. Samples received by pneumatic tube will not be accepted.
Quantity: requested: entire sample
minimum: 4 mL whole blood

Processing

Processing: UW-MT Instructions: Send specimens at room temperature to HMC within 3 hours of sample collection.

HMC Instructions: Take to HMC Hematology immediately.

Outside Laboratories: Deliver specimens at room temperature directly to HMC within 3 hours of sample collection.

Performance

LIS Dept Code

Performing Location(s)

HMC	Hematology 206-520-4600 325 9th Ave, Rm # GWH-47, Seattle, WA 98104-2420

Frequency

Daily

Available STAT?

Yes

Billing & Coding

CPT codes: 85576x2
LOINC: 18720-3
Interfaced Order Code: UOW2120