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Test Code LAB3326 Verify Now P2Y12 assay for Antiplatelet Effect

Important Note

Due to the special handling and time sensitivity, this test will be drawn ONLY on Butterworth Hospital inpatients and at the Butterworth Hospital and 35 Michigan outpatient laboratory locations.

Direct Venipuncture Reminder: Clearing tube must be drawn prior to collecting the vacuette tube. Both tubes must be labeled and sent together.

Test Name Alias

Verify Now P2Y12 | Clopidogrel | 152

Ordering Instructions

Due to the special handling and time sensitivity, this test will be drawn ONLY on Butterworth Hospital inpatients and at the Butterworth Hospital and 35 Michigan outpatient laboratory locations.

 

This is a test for P2Y12 inhibition by clopidogrel (Plavix), prasugel (Effient), or ticlopidine (Ticlid).  Direct IIb/IIIa inhibitors will interfere. In addition the P2Y12 test must not be performed within 48 hours after administration of eptifibatide (Integrilin) or tirofibrin (Aggrastat), or within 14 days after administration of abciximab (ReoPro)

Collection Instructions

Direct Venipuncture

Sample collection directly into vacuum collection tubes

 

Specimen Type: Whole blood
Container/Tube: 2 Greiner Bio-One partial-fill vacuette tubes with 3.2% sodium citrate (blue top). Greiner #454322
Volume: 2.0 mL each
Collection Instructions: 

  • Collect 2 tubes of whole blood using a 21 gauge or larger needle.
  • First collect a clearing tube (at least 2 mL) making sure the clearing tube does not contain any platelet inhibiting substances (e.g. EDTA).
  • Butterfly (21 gauge) is OK to use.
  • Fill the second tube (sample tube) to the black line (1/2 tube). Do not under fill.
  • If drawing blood for a CBC at the same time, fill the CBC tube last.
  • Gently invert the second tube at least 5 times to ensure complete mixing of the contents.
  • Samples with evidence of clotting should not be used.
  • Do not shake, as that may give incorrect results.
  • Label the tubes with the patient ID, date and time it was drawn.
  • Do not refrigerate.
  • Send both tubes!

 

Indwelling Catheter

Specimen Type: Whole blood
Container/Tube: 1 Greiner Bio-One partial-fill vacuette tube with 3.2% sodium citrate (blue top). Greiner #454322
Volume: 2.0 mL
Collection Instructions:

  • Discard the first 5 mL from an indwelling catheter to clear the line.
  • Ensure the catheter is free of clots.
  • Immediately transfer blood to a 2 mL Greiner Bio-One partial fill vacuette tube with 3.2% sodium citrate (blue top). Greiner #454322.
  • Fill to the black line (1/2 tube). Do not under fill.
  • If drawing blood for a CBC at the same time, fill the CBC tube last.
  • Gently invert the tube at least 5 times to ensure complete mixing of the contents.
  • Samples with evidence of clotting should not be used.
  • Do not shake as that may give incorrect results.
  • Label the tube with the patient ID, date and time it was drawn.
  • Do not refrigerate.

Please see Resources field to the left for more information.

 

Specimen Stability

Ambient: 4 hours

Refrigerate: Not Acceptable

Frozen: Not Acceptable

Laboratory Retention: 24 hours

Test Frequency

Available 24 hours, usual TAT 1 day.

Reference Range

Verify Now P2Y12 assay results are reported in Platelet Reactivity Units (PRU).

Lower PRU values are indicative of effective antiplatelet drug inhibition of platelet activity.

Higher PRU values are indicative of ineffective antiplatelet drug inhibition of platelet activity.

 

Patients on chronic clopidogrel (Plavix) therapy with PRU values at or below 180 are considered adequate responders.

 

Patients with PRU values at or above 208 may proceed to cardiac surgery. Patients with PRU values below 208 should have Verify Now P2Y12 repeated in 12-24 hours.

Performing Department

Coagulation

Performing Department Laboratory Location

Spectrum Health Regional Laboratory (SHRL), Grand Rapids, MI

Methodology

Point of Care (POC) utilizing platelet induced aggregation turbimetric optical detection

CPT

85576

CDM Code

4098608

Interface Order Alias

11641

LOINC

Verify Now P2Y12: 49010-2

Reviewed Date

7/13/2016