Individualised Antiplatelet Therapy - Is There a Role for Platelet Function Testing in Routine Clinical Practice?

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Abstract

Antiplatelet therapies are often used to minimise complications in patients with acute coronary syndromes or who are undergoing percutaneous coronary intervention with stenting. However, the occurrence of ‘high on-treatment platelet reactivity’ associated with the gold standard treatments aspirin and clopidogrel in a subset of individuals limits the efficacy of these drugs. This lack of response, which has been attributed to a genetic polymorphism, is associated with an increased risk of subsequent atherothrombotic events. In recent years, platelet function assays have been used to monitor antiplatelet inhibition. Various tests have been introduced that allow physicians to evaluate pharmacological response and potentially permit risk stratification of patients. While some of these assays have proved to be labour-intensive, the development of point-of-care assays may ease the time burden in clinical practice. Preliminary findings demonstrate the effectiveness of altering therapy based on assay results in terms of improving clinical outcomes, suggesting an important role for platelet function testing in the future of antiplatelet therapy.

Disclosure
The authors have no conflicts of interest to declare.
Correspondence
Jean-Philippe Collet, Institut de Cardiologie - INSERM U 937, Groupe Hospitalier Piti├®-Salp├¬tri├¿re, 47-83, Bd de l'hopital, 75013, Paris, France. E: jean-philippe.collet@psl.aphp.fr; Jochem Wouter van Werkum, Department of Cardiology, St Antonius Hospital Nieuwegein, Koekoekslaan 1, 3435 CM Nieuwegein, The Netherlands. E: woutervanwerkum@gmail.com
Received date
21 December 2009
Accepted date
08 March 2010
DOI
http://dx.doi.org/10.15420/icr.2010.5.1.96
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