The role of platelet function testing in risk stratification and clinical decision-making

Paul A. Gurbel; Udaya S. Tantry

doi:10.1016/j.iccl.2013.05.009

The role of platelet function testing in risk stratification and clinical decision-making

Paul A. Gurbel, Udaya S. Tantry

School of Medicine

Research output: Contribution to journal › Review article › peer-review

Abstract

Clopidogrel (a widely used second-generation thienopyridine) therapy is associated with an unpredictable pharmacodynamic response whereby approximately 1 in 3 patients will have a high on-treatment platelet reactivity to adenosine diphosphate. High on-treatment platelet reactivity is an established risk factor for ischemic event occurrence in patients undergoing percutaneous coronary intervention. Platelet function testing may have a role in monitoring therapeutic efficacy when clopidogrel is the chosen agent and in safety when more potent drugs are used, especially in patients with high bleeding risk. At this time, it seems most reasonable to assess platelet function in high-risk clopidogrel-treated patients.

Original language	English (US)
Pages (from-to)	607-614
Number of pages	8
Journal	Interventional Cardiology Clinics
Volume	2
Issue number	4
DOIs	https://doi.org/10.1016/j.iccl.2013.05.009
State	Published - Oct 2013

Keywords

Bleeding
Clopidogrel
High on-treatment platelet reactivity
P2Y receptor
Percutaneous coronary intervention
Platelet function testing

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.iccl.2013.05.009

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title = "The role of platelet function testing in risk stratification and clinical decision-making",

abstract = "Clopidogrel (a widely used second-generation thienopyridine) therapy is associated with an unpredictable pharmacodynamic response whereby approximately 1 in 3 patients will have a high on-treatment platelet reactivity to adenosine diphosphate. High on-treatment platelet reactivity is an established risk factor for ischemic event occurrence in patients undergoing percutaneous coronary intervention. Platelet function testing may have a role in monitoring therapeutic efficacy when clopidogrel is the chosen agent and in safety when more potent drugs are used, especially in patients with high bleeding risk. At this time, it seems most reasonable to assess platelet function in high-risk clopidogrel-treated patients.",

keywords = "Bleeding, Clopidogrel, High on-treatment platelet reactivity, P2Y receptor, Percutaneous coronary intervention, Platelet function testing",

author = "Gurbel, {Paul A.} and Tantry, {Udaya S.}",

note = "Funding Information: Disclosures: Dr Gurbel has received research funding from AstraZeneca , Daiichi Sankyo/Lilly , Sanofi-Aventis , CSL Pharmaceuticals , Accumetrics , Nanosphere and Haemonetics ; and honoraria and/or consultation fees from Merck , Daiichi Sankyo/Lilly, Boerhinger Ingleheim , Johnson and Johnson , AstraZeneca, Discovery Channel , and Bayer Healthcare . Dr Tantry reports receiving payment for lectures and receiving travel support from Accumetrics. ",

year = "2013",

month = oct,

doi = "10.1016/j.iccl.2013.05.009",

language = "English (US)",

volume = "2",

pages = "607--614",

journal = "Interventional Cardiology Clinics",

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publisher = "Elsevier BV",

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AU - Gurbel, Paul A.

AU - Tantry, Udaya S.

N1 - Funding Information: Disclosures: Dr Gurbel has received research funding from AstraZeneca , Daiichi Sankyo/Lilly , Sanofi-Aventis , CSL Pharmaceuticals , Accumetrics , Nanosphere and Haemonetics ; and honoraria and/or consultation fees from Merck , Daiichi Sankyo/Lilly, Boerhinger Ingleheim , Johnson and Johnson , AstraZeneca, Discovery Channel , and Bayer Healthcare . Dr Tantry reports receiving payment for lectures and receiving travel support from Accumetrics.

PY - 2013/10

Y1 - 2013/10

N2 - Clopidogrel (a widely used second-generation thienopyridine) therapy is associated with an unpredictable pharmacodynamic response whereby approximately 1 in 3 patients will have a high on-treatment platelet reactivity to adenosine diphosphate. High on-treatment platelet reactivity is an established risk factor for ischemic event occurrence in patients undergoing percutaneous coronary intervention. Platelet function testing may have a role in monitoring therapeutic efficacy when clopidogrel is the chosen agent and in safety when more potent drugs are used, especially in patients with high bleeding risk. At this time, it seems most reasonable to assess platelet function in high-risk clopidogrel-treated patients.

AB - Clopidogrel (a widely used second-generation thienopyridine) therapy is associated with an unpredictable pharmacodynamic response whereby approximately 1 in 3 patients will have a high on-treatment platelet reactivity to adenosine diphosphate. High on-treatment platelet reactivity is an established risk factor for ischemic event occurrence in patients undergoing percutaneous coronary intervention. Platelet function testing may have a role in monitoring therapeutic efficacy when clopidogrel is the chosen agent and in safety when more potent drugs are used, especially in patients with high bleeding risk. At this time, it seems most reasonable to assess platelet function in high-risk clopidogrel-treated patients.

KW - Bleeding

KW - Clopidogrel

KW - High on-treatment platelet reactivity

KW - P2Y receptor

KW - Percutaneous coronary intervention

KW - Platelet function testing

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JO - Interventional Cardiology Clinics

JF - Interventional Cardiology Clinics

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ER -

The role of platelet function testing in risk stratification and clinical decision-making

Abstract

Keywords

ASJC Scopus subject areas

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