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Blood. 2017 Aug 10;130(6):713-721. doi: 10.1182/blood-2017-03-742338. Epub 2017 Jun 9.

How I use laboratory monitoring of antiplatelet therapy.

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Center for Platelet Research Studies, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, and.
Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA.


Antiplatelet therapy is of proven benefit in coronary artery disease and a number of other clinical settings. This article reviews platelet function, molecular targets of antiplatelet agents, and clinical indications for antiplatelet therapy before focusing on a frequent question to hematologists about the 2 most commonly used antiplatelet therapies: Could the patient be aspirin "resistant" or clopidogrel "resistant"? If so, should results of a platelet function test be used to guide the dose or type of antiplatelet therapy? Whether such guided therapy is of clinical benefit to patients has been a source of controversy. The present article reviews this subject in the context of 2 prototypical clinical cases. Available evidence does not support the use of laboratory tests to guide the dose of aspirin or clopidogrel in patients with so-called aspirin or clopidogrel "resistance."

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