Platelet Function Testing and Tailored Antiplatelet Therapy

Dual antiplatelet therapy, consisting of aspirin and a P2Y12 receptor inhibitor, has dramatically reduced the incidence of atherothrombotic events for patients with acute coronary syndrome and those undergoing a percutaneous coronary intervention (PCI). However, the platelet inhibitory effect of clo...

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Bibliographic Details
Published in:Journal of cardiovascular translational research 2013-06, Vol.6 (3), p.316-328
Main Authors: Janssen, Paul W. A., ten Berg, Jurriën M.
Format: Article
Language:English
Subjects:
Biomedical Engineering and Bioengineering
Biomedicine
Blood Platelets - drug effects
Blood Platelets - metabolism
Cardiology
Coronary Thrombosis - blood
Coronary Thrombosis - etiology
Coronary Thrombosis - prevention & control
Drug Monitoring - methods
Drug Resistance
Hemorrhage - chemically induced
Human Genetics
Humans
Medicine
Medicine & Public Health
Patient Selection
Percutaneous Coronary Intervention - adverse effects
Platelet Activation - drug effects
Platelet Aggregation Inhibitors - adverse effects
Platelet Aggregation Inhibitors - therapeutic use
Platelet Function Tests
Precision Medicine
Predictive Value of Tests
Purinergic P2Y Receptor Antagonists - therapeutic use
Receptors, Purinergic P2Y12 - blood
Receptors, Purinergic P2Y12 - drug effects
Risk Factors
Treatment Outcome
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Summary:Dual antiplatelet therapy, consisting of aspirin and a P2Y12 receptor inhibitor, has dramatically reduced the incidence of atherothrombotic events for patients with acute coronary syndrome and those undergoing a percutaneous coronary intervention (PCI). However, the platelet inhibitory effect of clopidogrel, the most commonly used P2Y12 inhibitor, is variable between patients. Patients exhibiting high platelet reactivity (HPR) despite clopidogrel treatment are at higher risk of recurrent atherothrombotic events after PCI. In order to reduce the incidence of HPR, the more potent P2Y12 receptor inhibitors prasugrel and ticagrelor are used. However, these drugs increase the risk of bleeding. As there is evidence of a therapeutic window for platelet inhibition, platelet function tests could be helpful for tailoring antiplatelet therapy based on the patient’s thrombotic and bleeding risk. In the present article, we review the most commonly used platelet function tests and the current evidence for tailoring of antiplatelet therapy in PCI patients.
ISSN:1937-5387
1937-5395
DOI:10.1007/s12265-013-9458-z