Update: Acute coronary syndromes (V). Personalized antiplatelet therapy

Rev Esp Cardiol (Engl Ed). 2014 Jun;67(6):480-7. doi: 10.1016/j.rec.2014.01.012. Epub 2014 May 1.

Abstract

It is well established that high on-treatment platelet reactivity to adenosine diphosphate during clopidogrel therapy is an independent risk factor for ischemic event occurrences in a postpercutaneous coronary intervention patients. However, the precise role of platelet function testing remains debated. Platelet function testing to ensure optimal platelet inhibition has been recommended by some authorities to improve outcomes in patients treated with clopidogrel. Recent prospective, randomized trials of personalized antiplatelet therapy have failed to demonstrate a benefit of platelet function testing in improving outcomes. In this review article, we discuss the mechanisms responsible for clopidogrel nonreponsiveness, recent trials of platelet function testing, and other new developments in the field of personalized antiplatelet therapy.

Keywords: Determinación de genotipo; Genotyping; Personalized antiplatelet therapy; Platelet function testing; Pruebas de la función plaquetaria; Thrombosis; Tratamiento antiagregante plaquetario personalizado; Trombosis.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / drug therapy*
  • Clopidogrel
  • Humans
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Precision Medicine
  • Randomized Controlled Trials as Topic
  • Ticlopidine / analogs & derivatives
  • Ticlopidine / therapeutic use
  • Treatment Failure

Substances

  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Ticlopidine