High Residual Platelet Reactivity After Clopidogrel Loading and Long-term Cardiovascular Events Among Patients With Acute Coronary Syndromes Undergoing PCI

Abstract

clinicaltrials.gov Identifier: NCT01231035.

Impact of Obstructive Sleep Apnea on Platelet Function Profiles in Patients With Acute Coronary Syndrome Taking Dual Antiplatelet Therapy

“…In patients with ACS or undergoing PCI, HRPR is associated with ≈2‐ to 3‐fold greater risk of recurrent ischemic events and about 1.5‐fold greater risk of all‐cause mortality 27, 28, 29. In particular, this study shows a broad variability platelet function profiles in patients receiving clopidogrel, and OSA is associated with reduced clopidogrel‐induced antiplatelet effects and a greater likelihood of having HRPR.…”

Recommendations for the standardization of light transmission aggregometry: a consensus of the working party from the platelet physiology subcommittee of SSC/ISTH

“…New, faster and more efficient point-of-care tests are available for this purpose, but LTA could be used when the new tests are not available. However, based on the negative results of three large randomized controlled trials [31][32][33], which used the point-of-care test VerifyNow P2Y 12 , and a large non randomized, non controlled study, which used LTA to tailor antiplatelet treatment with clopidogrel [34], convincing data for recommending monitoring antiplatelet therapy by laboratory tests, including LTA, are still lacking.…”

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

“…Wykazano, że podwójne leczenie przeciwpłytkowe (DAPT) powoduje zmniejszenie nawrotów incydentów niedokrwiennych w NSTE-ACS w porównaniu z monoterapią ASA [137,138]. Jednak nawet 10% pacjentów leczonych połączeniem ASA i klopidogrelu będzie miało nawrót incydentu niedokrwiennego w pierwszym roku po ACS, z częstością występowania zakrzepicy w stencie wynoszącą do 2% [139]. To rezydualne ryzyko może być częściowo wyjaśnione niepełnym hamowaniem płytek krwi z powodu niewystarczającej odpowiedzi na klopidogrel.…”