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Platelet function testing and tailored antiplatelet therapy.

Abstract
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.
AuthorsPaul W A Janssen, Jurriën M ten Berg
JournalJournal of cardiovascular translational research (J Cardiovasc Transl Res) Vol. 6 Issue 3 Pg. 316-28 (Jun 2013) ISSN: 1937-5395 [Electronic] United States
PMID23543615 (Publication Type: Journal Article, Review)
Chemical References
  • P2RY12 protein, human
  • Platelet Aggregation Inhibitors
  • Purinergic P2Y Receptor Antagonists
  • Receptors, Purinergic P2Y12
Topics
  • Blood Platelets (drug effects, metabolism)
  • Coronary Thrombosis (blood, etiology, prevention & control)
  • Drug Monitoring (methods)
  • Drug Resistance
  • Hemorrhage (chemically induced)
  • Humans
  • Patient Selection
  • Percutaneous Coronary Intervention (adverse effects)
  • Platelet Activation (drug effects)
  • Platelet Aggregation Inhibitors (adverse effects, therapeutic use)
  • Platelet Function Tests
  • Precision Medicine
  • Predictive Value of Tests
  • Purinergic P2Y Receptor Antagonists (therapeutic use)
  • Receptors, Purinergic P2Y12 (blood, drug effects)
  • Risk Factors
  • Treatment Outcome

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