scholarly journals Should Platelet Function Testing Guide Antiplatelet Therapy for Patients with Coronary Artery Stenting or Acute Coronary Syndromes?

2013 ◽  
Vol 59 (9) ◽  
pp. 1299-1300 ◽  
Author(s):  
Kevin P Cohoon ◽  
John A Heit
Keyword(s):  
Coronary Artery ◽  
Antiplatelet Therapy ◽  
Platelet Function ◽  
Acute Coronary Syndromes ◽  
Platelet Function Testing ◽  
Coronary Artery Stenting ◽  
Coronary Syndromes ◽  
Function Testing

scholarly journals Receptor Inhibitors in Acute Coronary Syndromes: What Is New on the Horizon?

2013 ◽  
Vol 2013 ◽  
pp. 1-15 ◽  
Author(s):  
Adriana Dana Oprea ◽  
Wanda M. Popescu
Keyword(s):  
Antiplatelet Therapy ◽  
Platelet Function ◽  
Acute Coronary Syndromes ◽  
Point Of Care ◽  
Variable Response ◽  
Pharmacodynamic Interaction ◽  
Platelet Function Testing ◽  
Percutaneous Coronary ◽  
Coronary Syndromes ◽  
Function Testing

Dual antiplatelet therapy with aspirin and a P2Y12receptor inhibitor represents the cornerstone therapy for patients with acute coronary syndromes or undergoing percutaneous interventions, leading to a reduction of subsequent ischemic events. Variable response to clopidogrel has received close attention, and pharmacokinetic, pharmacodynamic, and pharmacogenomic factors have been identified as culprits. This led to the introduction of newer, potentially safer, and more effective antiplatelet agents (prasugrel and ticagrelor). Additionally, several point-of-care assays of platelet function have been developed in recent years to rapidly screen individuals on antiplatelet therapy. While the routine use of platelet function testing is uncertain and not currently recommended, it may be useful in instances when the degree of platelet inhibition may be uncertain such as high-risk patients undergoing percutaneous coronary intervention or when there may be a suspected pharmacodynamic interaction with other drugs. The current paper focuses on the P2Y12receptor inhibitors and their pharmacogenetics and indications in patients with acute coronary syndromes or receiving percutaneous coronary interventions as well as the applicability of platelet function testing in this clinical context.

scholarly journals Platelet count and platelet function testing in acute coronary syndromes

2014 ◽  
Vol 23 ◽  
pp. e26
Author(s):  
K. Hally ◽  
L. Johnston ◽  
A. Holley ◽  
P. Larsen ◽  
S. Harding
Keyword(s):  
Platelet Count ◽  
Platelet Function ◽  
Acute Coronary Syndromes ◽  
Platelet Function Testing ◽  
Coronary Syndromes ◽  
Function Testing

Individualised Antiplatelet Therapy – Is There a Role for Platelet Function Testing in Routine Clinical Practice?

2010 ◽  
Vol 5 (1) ◽  
pp. 96 ◽  
Author(s):  
Collet Jean-Philippe ◽  
Jochem Wouter van Werkum ◽  
◽  
Keyword(s):  
Clinical Practice ◽  
Antiplatelet Therapy ◽  
Platelet Function ◽  
Platelet Reactivity ◽  
Point Of Care ◽  
Coronary Intervention ◽  
Platelet Function Testing ◽  
Increased Risk ◽  
Coronary Syndromes ◽  
Function Testing

Antiplatelet therapies are often used to minimise complications in patients with acute coronary syndromes or who are undergoing percutaneous coronary intervention with stenting. However, the occurrence of ‘high on-treatment platelet reactivity’ associated with the gold standard treatments aspirin and clopidogrel in a subset of individuals limits the efficacy of these drugs. This lack of response, which has been attributed to a genetic polymorphism, is associated with an increased risk of subsequent atherothrombotic events. In recent years, platelet function assays have been used to monitor antiplatelet inhibition. Various tests have been introduced that allow physicians to evaluate pharmacological response and potentially permit risk stratification of patients. While some of these assays have proved to be labour-intensive, the development of point-of-care assays may ease the time burden in clinical practice. Preliminary findings demonstrate the effectiveness of altering therapy based on assay results in terms of improving clinical outcomes, suggesting an important role for platelet function testing in the future of antiplatelet therapy.

Individualised Antiplatelet Therapy – Is There a Role for Platelet Function Testing in Routine Clinical Practice?

2010 ◽  
Vol 6 (1) ◽  
pp. 41 ◽  
Author(s):  
Collet Jean-Philippe ◽  
Jochem Wouter van Werkum ◽  
◽  
Keyword(s):  
Clinical Practice ◽  
Antiplatelet Therapy ◽  
Platelet Function ◽  
Platelet Reactivity ◽  
Point Of Care ◽  
Coronary Intervention ◽  
Platelet Function Testing ◽  
Increased Risk ◽  
Coronary Syndromes ◽  
Function Testing

Antiplatelet therapies are often used to minimise complications in patients with acute coronary syndromes or who are undergoing percutaneous coronary intervention with stenting. However, the occurrence of ‘high on-treatment platelet reactivity’ associated with the gold standard treatments aspirin and clopidogrel in a subset of individuals limits the efficacy of these drugs. This lack of response, which has been attributed to a genetic polymorphism, is associated with an increased risk of subsequent atherothrombotic events. In recent years, platelet function assays have been used to monitor antiplatelet inhibition. Various tests have been introduced that allow physicians to evaluate pharmacological response and potentially permit risk stratification of patients. While some of these assays have proved to be labour-intensive, the development of point-of-care assays may ease the time burden in clinical practice. Preliminary findings demonstrate the effectiveness of altering therapy based on assay results in terms of improving clinical outcomes, suggesting an important role for platelet function testing in the future of antiplatelet therapy.

scholarly journals IMPACT OF POINT-OF-CARE PLATELET FUNCTION TESTING AMONG PATIENTS WITH AND WITHOUT ACUTE CORONARY SYNDROMES UNDERGOING PCI WITH DRUG-ELUTING STENTS: AN ADAPT-DES SUBSTUDY

2012 ◽  
Vol 59 (13) ◽  
pp. E291 ◽  
Author(s):  
Ajay J. Kirtane ◽  
Michael Rinaldi ◽  
Helen Parise ◽  
Bernhard Witzenbichler ◽  
Giora Weisz ◽  
...  
Keyword(s):  
Platelet Function ◽  
Acute Coronary Syndromes ◽  
Point Of Care ◽  
Drug Eluting Stents ◽  
Platelet Function Testing ◽  
Drug Eluting ◽  
Coronary Syndromes ◽  
Function Testing

scholarly journals CRT-34 Outcomes Of Anti-platelet Therapy For Acute Coronary Syndromes Patients Directed By Post Pci Platelet Function Testing In A Real World Setting

2013 ◽  
Vol 6 (2) ◽  
pp. S11-S12
Author(s):  
Elad Asher ◽  
Perry Anarado ◽  
Myttle Mayuga ◽  
Martin Bradley ◽  
Ka Chun Alan Chan ◽  
...  
Keyword(s):  
Platelet Function ◽  
Real World ◽  
Acute Coronary Syndromes ◽  
Platelet Function Testing ◽  
Real World Setting ◽  
Anti Platelet Therapy ◽  
Coronary Syndromes ◽  
Function Testing

Platelet function testing and risk of bleeding complications

2010 ◽  
Vol 103 (06) ◽  
pp. 1128-1135 ◽  
Author(s):  
José Luis Ferreiro ◽  
Dirk Sibbing ◽  
Dominick Angiolillo
Keyword(s):  
Antiplatelet Therapy ◽  
Platelet Function ◽  
Platelet Inhibition ◽  
Bleeding Complications ◽  
Individual Response ◽  
Bleeding Events ◽  
Platelet Function Testing ◽  
Risk Of Bleeding ◽  
Potential Applications ◽  
Function Testing

SummaryAntiplatelet therapy has a key role in preventing atherothrombotic events in patients with coronary artery disease, particularly in those undergoing revascularisation procedures. However, this may occur at the expense of an increase risk of bleeding. Therefore, the balance between thrombotic and bleeding events is critical in order to achieve optimal outcomes. Since there is a broad variability in individual response profiles to antiplatelet therapy, these outcomes (thrombosis vs. bleeding) may depend on the level of platelet inhibition achieved in a given subject. Platelet function assays have emerged as a useful tool for its potential to determine patients at a higher risk of ischaemic and bleeding complications. The present manuscript will review the available evidence associating platelet function testing with adverse clinical outcomes, in particular bleeding, and their potential applications in lieu of novel and more potent antithrombotic agents that will be introduced into clinical practice in the near future.

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