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 language | English (US) |
|---|---|
| Pages (from-to) | 919-933 |
| Number of pages | 15 |
| Journal | Journal of the American College of Cardiology |
| Volume | 56 |
| Issue number | 12 |
| DOIs | |
| State | Published - Sep 14 2010 |
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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 journal › Article
}
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 -