Importance of measurement of platelet reactivity to ADP in patients with coronary artery disease: An historical account

Udaya S. Tantry, Elisabeth Mahla, Martin G. Gesheff, Paul A. Gurbel

Research output: Contribution to journalReview article

Abstract

The pivotal roles of platelets in physiological hemostasis and pathological thrombosis at the site of plaque rupture are well established. The latter roles provide the fundamental basis for the most widely implemented pharmacologic management of coronary artery disease-dual antiplatelet therapy with aspirin to inhibit platelet thromboxane A2 generation, and a P2Y12 receptor inhibitor to prevent adenosine diphosphate (ADP)-induced platelet activation. Although suboptimal pharmacodynamic efficacy, also described as high on-treatment platelet reactivity to ADP, has been associated with greater risk for post-stenting ischemic event occurrence, enhanced responsiveness is associated with higher risk for bleeding in selected patients. In this review article, we aim to provide an historical account of the one and a half century long journey starting with the first description of platelets through the first report of ex vivo measurement of ADP-induced platelet aggregation, the first demonstration of an association between ADP-induced platelet aggregation and post-stenting ischemic event occurrence, and finally to the most recent description of a 'therapeutic window' concept for P2Y12 receptor inhibitor therapy.

Original languageEnglish (US)
Pages (from-to)1547-1556
Number of pages10
JournalExpert review of cardiovascular therapy
Volume11
Issue number11
DOIs
StatePublished - Nov 15 2013

Keywords

  • P2Y receptor
  • clopidogrel
  • coronary artery disease
  • dual antiplatelet therapy
  • high platelet reactivity
  • personalized antiplatelet therapy
  • platelet
  • platelet function assays

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

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