Measuring antiplatelet drug effects in the laboratory

Thromb Res. 2007;120(3):323-36. doi: 10.1016/j.thromres.2006.11.012. Epub 2007 Jan 17.

Abstract

This review discusses the advantages and disadvantages of currently available tests for the monitoring of antiplatelet therapy (especially aspirin and clopidogrel). Many tests of platelet function are now available for clinical use, and some of these tests have been shown to predict clinical outcomes after antiplatelet therapy. However, in most of these studies, the number of major adverse clinical events was low. No published studies address the clinical effectiveness of altering therapy based on the results of monitoring antiplatelet therapy. Therefore, the correct treatment, if any, of "resistance" to antiplatelet therapy is unknown and, other than in research trials, monitoring of antiplatelet therapy in patients is not generally recommended. A clinically meaningful definition of "resistance" to antiplatelet drugs needs to be developed, based on data linking drug-dependent laboratory tests to clinical outcomes in patients.

Publication types

  • Review

MeSH terms

  • Aspirin / pharmacology
  • Blood Platelets / drug effects*
  • Clopidogrel
  • Drug Resistance
  • Humans
  • Laboratories*
  • Platelet Aggregation Inhibitors / pharmacology*
  • Platelet Function Tests / instrumentation
  • Platelet Function Tests / methods
  • Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors
  • Ticlopidine / analogs & derivatives
  • Ticlopidine / pharmacology

Substances

  • Platelet Aggregation Inhibitors
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Clopidogrel
  • Ticlopidine
  • Aspirin