Point-of-care platelet function testing in patients undergoing PCI: between a rock and a hard place

被引:7
作者
van Werkum, J. W. [1 ]
Hackeng, C. M. [2 ]
de Korte, F. I. [4 ]
Verheugt, F. W. A. [3 ]
ten Berg, J. M. [1 ]
机构
[1] St Antonius Hosp, Dept Cardiol, NL-3430 EM Nieuwegein, Netherlands
[2] St Antonius Hosp, Dept Clin Chem, NL-3430 EM Nieuwegein, Netherlands
[3] Radboud Univ Nijmegen, Med Ctr, Dept Cardiol, Nijmegen, Netherlands
[4] Univ Med Ctr Utrecht, Dept Cardiol, Utrecht, Netherlands
关键词
monitoring; antiplatelet therapy; platelets; clopidogrel; aspirin;
D O I
10.1007/BF03086004
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Since recent studies have linked an impaired response to antiplatelet therapy with a higher incidence of atherothrombotic events, the monitoring of the efficacy of antiplatelet therapy in the individual patient has attracted much attention. In the present report, we demonstrate that platelet function testing with several point-of-care assays results in ambiguous and conflicting results: some assays indicated that the patient's platelets were insufficiently inhibited by clopidogrel whereas other assays reported an adequate response. Therefore, platelet function assays should not be used solely to guide treatment decisions, and tailor-made antithrombotic treatment has to wait for the most predictive platelet function test to emerge for measuring the risk for thrombotic complications after stenting. Until then, daily clinical practice should not be guided by point-of-care platelet function testing.
引用
收藏
页码:299 / 305
页数:7
相关论文
共 25 条
  • [1] Resistance to thienopyridines: Clinical detection of coronary stent thrombosis by monitoring of vasodilator-stimulated phosphoprotein phosphorylation
    Barragan, P
    Bouvier, JL
    Roquebert, PO
    Macaluso, G
    Commeau, P
    Comet, B
    Lafont, A
    Camoin, L
    Walter, U
    Eigenthaler, M
    [J]. CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2003, 59 (03) : 295 - 302
  • [2] Aspirin resistance is associated with a high incidence of myonecrosis after non-urgent percutaneous coronary intervention despite clopidogrel pretreatment
    Chen, WH
    Lee, PY
    Ng, W
    Tse, HF
    Lau, CP
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2004, 43 (06) : 1122 - 1126
  • [3] Benefit of a 600-mg loading dose of clopidogrel on platelet reactivity and clinical outcomes in patients with non-ST-segment elevation acute coronary syndrome undergoing coronary stenting
    Cuisset, Thomas
    Frere, Corinne
    Quilici, Jacques
    Morange, Pierre-Emmanuel
    Nait-Saidi, Lyassine
    Carvajal, Joseph
    Lehmann, Agnes
    Lambert, Marc
    Bonnet, Jean-Louis
    Alessi, Marie-Christine
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2006, 48 (07) : 1339 - 1345
  • [4] Cutlip DE, 2001, CIRCULATION, V103, P1967
  • [5] Pathological mechanisms of fatal late coronary stent thrombosis in humans
    Farb, A
    Burke, AP
    Kolodgie, FD
    Virmani, R
    [J]. CIRCULATION, 2003, 108 (14) : 1701 - 1706
  • [6] Low response to clopidogrel is associated with cardiovascular outcome after coronary stent implantation
    Geisler, Tobias
    Langer, Harald
    Wydymus, Magdalena
    Goehring, Katrin
    Zuern, Christine
    Bigalke, Boris
    Stellos, Konstantinos
    May, Andreas E.
    Gawaz, Meinrad
    [J]. EUROPEAN HEART JOURNAL, 2006, 27 (20) : 2420 - 2425
  • [7] Limited usefulness of the PFA-100™ for the monitoring of ADP receptor antagonists -: in vitro experience
    Golanski, J
    Pluta, J
    Baraniak, J
    Watala, C
    [J]. CLINICAL CHEMISTRY AND LABORATORY MEDICINE, 2004, 42 (01) : 25 - 29
  • [8] Platelet reactivity in patients and recurrent events post-stenting - Results of the PREPARE POST-STENTlNG study
    Gurbel, PA
    Bliden, KP
    Guyer, K
    Cho, PW
    Zaman, KA
    Kreutz, RP
    Bassi, AK
    Tantry, US
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2005, 46 (10) : 1820 - 1826
  • [9] Clopidogrel for coronary stenting - Response variability, drug resistance, and the effect of pretreatment platelet reactivity
    Gurbel, PA
    Bliden, KP
    Hiatt, BL
    O'Connor, CM
    [J]. CIRCULATION, 2003, 107 (23) : 2908 - 2913
  • [10] Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents
    Iakovou, I
    Schmidt, T
    Bonizzoni, E
    Ge, L
    Sangiorgi, GM
    Stankovic, G
    Airoldi, F
    Chieffo, A
    Montorfano, M
    Carlino, M
    Michev, I
    Corvaja, N
    Briguori, C
    Gerckens, U
    Grube, E
    Colombo, A
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 293 (17): : 2126 - 2130