Consensus and future directions on the definition of high on-treatment platelet reactivity to adenosine diphosphate

Laurent Bonello, Udaya S. Tantry, Rossella Marcucci, Ruediger Blindt, Dominick J. Angiolillo, Richard Becker, Deepak L. Bhatt, Marco Cattaneo, Jean Philippe Collet, Thomas Cuisset, Christian Gachet, Gilles Montalescot, Lisa K. Jennings, Dean Kereiakes, Dirk Sibbing, Dietmar Trenk, Jochem W. Van Werkum, Franck Paganelli, Matthew J. Price, Ron Waksman & 1 others Paul A. Gurbel

Research output: Contribution to journalArticle

Abstract

The addition of clopidogrel to aspirin treatment reduces ischemic events in a wide range of patients with cardiovascular disease. However, recurrent ischemic event occurrence during dual antiplatelet therapy, including stent thrombosis, remains a major concern. Platelet function measurements during clopidogrel treatment demonstrated a variable and overall modest level of P2Y12 inhibition. High on-treatment platelet reactivity to adenosine diphosphate (ADP) was observed in selected patients. Multiple studies have now demonstrated a clear association between high on-treatment platelet reactivity to ADP measured by multiple methods and adverse clinical event occurrence. However, the routine measurement of platelet reactivity has not been widely implemented and recommended in the guidelines. Reasons for the latter include: 1) a lack of consensus on the optimal method to quantify high on-treatment platelet reactivity and the cutoff value associated with clinical risk; and 2) limited data to support that alteration of therapy based on platelet function measurements actually improves outcomes. This review provides a consensus opinion on the definition of high on-treatment platelet reactivity to ADP based on various methods reported in the literature and proposes how this measurement may be used in the future care of patients.

Original languageEnglish (US)
Pages (from-to)919-933
Number of pages15
JournalJournal of the American College of Cardiology
Volume56
Issue number12
DOIs
StatePublished - Sep 14 2010

Fingerprint

Adenosine Diphosphate
Blood Platelets
clopidogrel
Therapeutics
Direction compound
Aspirin
Stents
Patient Care
Thrombosis
Cardiovascular Diseases
Guidelines

Keywords

  • adenosine diphosphate
  • percutaneous coronary intervention
  • platelet reactivity
  • thrombotic events

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Consensus and future directions on the definition of high on-treatment platelet reactivity to adenosine diphosphate. / Bonello, Laurent; Tantry, Udaya S.; Marcucci, Rossella; Blindt, Ruediger; Angiolillo, Dominick J.; Becker, Richard; Bhatt, Deepak L.; Cattaneo, Marco; Collet, Jean Philippe; Cuisset, Thomas; Gachet, Christian; Montalescot, Gilles; Jennings, Lisa K.; Kereiakes, Dean; Sibbing, Dirk; Trenk, Dietmar; Van Werkum, Jochem W.; Paganelli, Franck; Price, Matthew J.; Waksman, Ron; Gurbel, Paul A.

In: Journal of the American College of Cardiology, Vol. 56, No. 12, 14.09.2010, p. 919-933.

Research output: Contribution to journalArticle

Bonello, L, Tantry, US, Marcucci, R, Blindt, R, Angiolillo, DJ, Becker, R, Bhatt, DL, Cattaneo, M, Collet, JP, Cuisset, T, Gachet, C, Montalescot, G, Jennings, LK, Kereiakes, D, Sibbing, D, Trenk, D, Van Werkum, JW, Paganelli, F, Price, MJ, Waksman, R & Gurbel, PA 2010, 'Consensus and future directions on the definition of high on-treatment platelet reactivity to adenosine diphosphate', Journal of the American College of Cardiology, vol. 56, no. 12, pp. 919-933. https://doi.org/10.1016/j.jacc.2010.04.047
Bonello, Laurent ; Tantry, Udaya S. ; Marcucci, Rossella ; Blindt, Ruediger ; Angiolillo, Dominick J. ; Becker, Richard ; Bhatt, Deepak L. ; Cattaneo, Marco ; Collet, Jean Philippe ; Cuisset, Thomas ; Gachet, Christian ; Montalescot, Gilles ; Jennings, Lisa K. ; Kereiakes, Dean ; Sibbing, Dirk ; Trenk, Dietmar ; Van Werkum, Jochem W. ; Paganelli, Franck ; Price, Matthew J. ; Waksman, Ron ; Gurbel, Paul A. / Consensus and future directions on the definition of high on-treatment platelet reactivity to adenosine diphosphate. In: Journal of the American College of Cardiology. 2010 ; Vol. 56, No. 12. pp. 919-933.
@article{2da6f3887791431ba6caad945feb8dad,
title = "Consensus and future directions on the definition of high on-treatment platelet reactivity to adenosine diphosphate",
abstract = "The addition of clopidogrel to aspirin treatment reduces ischemic events in a wide range of patients with cardiovascular disease. However, recurrent ischemic event occurrence during dual antiplatelet therapy, including stent thrombosis, remains a major concern. Platelet function measurements during clopidogrel treatment demonstrated a variable and overall modest level of P2Y12 inhibition. High on-treatment platelet reactivity to adenosine diphosphate (ADP) was observed in selected patients. Multiple studies have now demonstrated a clear association between high on-treatment platelet reactivity to ADP measured by multiple methods and adverse clinical event occurrence. However, the routine measurement of platelet reactivity has not been widely implemented and recommended in the guidelines. Reasons for the latter include: 1) a lack of consensus on the optimal method to quantify high on-treatment platelet reactivity and the cutoff value associated with clinical risk; and 2) limited data to support that alteration of therapy based on platelet function measurements actually improves outcomes. This review provides a consensus opinion on the definition of high on-treatment platelet reactivity to ADP based on various methods reported in the literature and proposes how this measurement may be used in the future care of patients.",
keywords = "adenosine diphosphate, percutaneous coronary intervention, platelet reactivity, thrombotic events",
author = "Laurent Bonello and Tantry, {Udaya S.} and Rossella Marcucci and Ruediger Blindt and Angiolillo, {Dominick J.} and Richard Becker and Bhatt, {Deepak L.} and Marco Cattaneo and Collet, {Jean Philippe} and Thomas Cuisset and Christian Gachet and Gilles Montalescot and Jennings, {Lisa K.} and Dean Kereiakes and Dirk Sibbing and Dietmar Trenk and {Van Werkum}, {Jochem W.} and Franck Paganelli and Price, {Matthew J.} and Ron Waksman and Gurbel, {Paul A.}",
year = "2010",
month = "9",
day = "14",
doi = "10.1016/j.jacc.2010.04.047",
language = "English (US)",
volume = "56",
pages = "919--933",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "12",

}

TY - JOUR

T1 - Consensus and future directions on the definition of high on-treatment platelet reactivity to adenosine diphosphate

AU - Bonello, Laurent

AU - Tantry, Udaya S.

AU - Marcucci, Rossella

AU - Blindt, Ruediger

AU - Angiolillo, Dominick J.

AU - Becker, Richard

AU - Bhatt, Deepak L.

AU - Cattaneo, Marco

AU - Collet, Jean Philippe

AU - Cuisset, Thomas

AU - Gachet, Christian

AU - Montalescot, Gilles

AU - Jennings, Lisa K.

AU - Kereiakes, Dean

AU - Sibbing, Dirk

AU - Trenk, Dietmar

AU - Van Werkum, Jochem W.

AU - Paganelli, Franck

AU - Price, Matthew J.

AU - Waksman, Ron

AU - Gurbel, Paul A.

PY - 2010/9/14

Y1 - 2010/9/14

N2 - The addition of clopidogrel to aspirin treatment reduces ischemic events in a wide range of patients with cardiovascular disease. However, recurrent ischemic event occurrence during dual antiplatelet therapy, including stent thrombosis, remains a major concern. Platelet function measurements during clopidogrel treatment demonstrated a variable and overall modest level of P2Y12 inhibition. High on-treatment platelet reactivity to adenosine diphosphate (ADP) was observed in selected patients. Multiple studies have now demonstrated a clear association between high on-treatment platelet reactivity to ADP measured by multiple methods and adverse clinical event occurrence. However, the routine measurement of platelet reactivity has not been widely implemented and recommended in the guidelines. Reasons for the latter include: 1) a lack of consensus on the optimal method to quantify high on-treatment platelet reactivity and the cutoff value associated with clinical risk; and 2) limited data to support that alteration of therapy based on platelet function measurements actually improves outcomes. This review provides a consensus opinion on the definition of high on-treatment platelet reactivity to ADP based on various methods reported in the literature and proposes how this measurement may be used in the future care of patients.

AB - The addition of clopidogrel to aspirin treatment reduces ischemic events in a wide range of patients with cardiovascular disease. However, recurrent ischemic event occurrence during dual antiplatelet therapy, including stent thrombosis, remains a major concern. Platelet function measurements during clopidogrel treatment demonstrated a variable and overall modest level of P2Y12 inhibition. High on-treatment platelet reactivity to adenosine diphosphate (ADP) was observed in selected patients. Multiple studies have now demonstrated a clear association between high on-treatment platelet reactivity to ADP measured by multiple methods and adverse clinical event occurrence. However, the routine measurement of platelet reactivity has not been widely implemented and recommended in the guidelines. Reasons for the latter include: 1) a lack of consensus on the optimal method to quantify high on-treatment platelet reactivity and the cutoff value associated with clinical risk; and 2) limited data to support that alteration of therapy based on platelet function measurements actually improves outcomes. This review provides a consensus opinion on the definition of high on-treatment platelet reactivity to ADP based on various methods reported in the literature and proposes how this measurement may be used in the future care of patients.

KW - adenosine diphosphate

KW - percutaneous coronary intervention

KW - platelet reactivity

KW - thrombotic events

UR - http://www.scopus.com/inward/record.url?scp=77953911457&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953911457&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2010.04.047

DO - 10.1016/j.jacc.2010.04.047

M3 - Article

VL - 56

SP - 919

EP - 933

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 12

ER -