Monitoring the effectiveness of antiplatelet therapy: opportunities and limitations
Monitoring the effectiveness of antiplatelet therapy: opportunities and limitations
Previous clinical studies have shown heterogeneity in individual patient responses to antiplatelet therapy and high residual platelet reactivity is associated with increased risk of adverse clinical events. Monitoring response to antiplatelet therapy and tailoring treatment accordingly is currently not recommended in routine clinical practice largely due to the lack of a standardized definition of antiplatelet therapy hyporesponse and the need for a widely accepted point-of-care platelet function test that can be reliably utilized in frontline clinical practice. Recent data have shown that titrating the dose of clopidogrel in patients undergoing percutaneous coronary intervention significantly reduces the incidence of major adverse cardiovascular events and large-scale clinical trials are currently underway to investigate whether individually tailored treatment based on results of platelet function testing leads to improved clinical outcome. Furthermore, genetic testing has demonstrated a link between CYP2C19 genetic polymorphisms, altered clopidogrel metabolite concentrations and adverse clinical events. Clinical studies are currently underway to investigate the potential clinical benefit associated with genotype-guided tailoring of antiplatelet therapy. With the advent of newer, more potent antiplatelet agents and their associated increased bleeding risks, it will become imperative in the future to select the most appropriate, safe and effective drug.
aspirin, clopidogrel, platelet function, testing, platelets, stent thrombosis
683-696
Sambu, Nalyaka
7d0ba3fb-e39e-48d7-a0e4-ce249acc5980
Curzen, N.
70f3ea49-51b1-418f-8e56-8210aef1abf4
October 2011
Sambu, Nalyaka
7d0ba3fb-e39e-48d7-a0e4-ce249acc5980
Curzen, N.
70f3ea49-51b1-418f-8e56-8210aef1abf4
Sambu, Nalyaka and Curzen, N.
(2011)
Monitoring the effectiveness of antiplatelet therapy: opportunities and limitations.
[in special issue: Haemostasis Themed Issue]
British Journal of Clinical Pharmacology, 72 (4), .
(doi:10.1111/j.1365-2125.2011.03955.x).
(PMID:21366666)
Abstract
Previous clinical studies have shown heterogeneity in individual patient responses to antiplatelet therapy and high residual platelet reactivity is associated with increased risk of adverse clinical events. Monitoring response to antiplatelet therapy and tailoring treatment accordingly is currently not recommended in routine clinical practice largely due to the lack of a standardized definition of antiplatelet therapy hyporesponse and the need for a widely accepted point-of-care platelet function test that can be reliably utilized in frontline clinical practice. Recent data have shown that titrating the dose of clopidogrel in patients undergoing percutaneous coronary intervention significantly reduces the incidence of major adverse cardiovascular events and large-scale clinical trials are currently underway to investigate whether individually tailored treatment based on results of platelet function testing leads to improved clinical outcome. Furthermore, genetic testing has demonstrated a link between CYP2C19 genetic polymorphisms, altered clopidogrel metabolite concentrations and adverse clinical events. Clinical studies are currently underway to investigate the potential clinical benefit associated with genotype-guided tailoring of antiplatelet therapy. With the advent of newer, more potent antiplatelet agents and their associated increased bleeding risks, it will become imperative in the future to select the most appropriate, safe and effective drug.
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Published date: October 2011
Keywords:
aspirin, clopidogrel, platelet function, testing, platelets, stent thrombosis
Organisations:
Human Development & Health
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Local EPrints ID: 355215
URI: http://eprints.soton.ac.uk/id/eprint/355215
ISSN: 0306-5251
PURE UUID: 5fde17fd-1d0a-4f3c-946a-dfc401588480
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Date deposited: 19 Aug 2013 10:23
Last modified: 15 Mar 2024 03:23
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Author:
Nalyaka Sambu
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