The clinical potential of a point-of-care assay to assess interindividual variability in platelet aggregation among patients taking clopidogrel.
Clopidogrel is an important component of medical therapy for patients with acute coronary syndromes and those receiving coronary artery stents. Despite use of clopidogrel, a significant number of patients experience recurrent adverse ischemic events. Interindividual variability of platelet aggregation in response to clopidogrel may be an explanation for some of these recurrent events, and small trials have linked "clopidogrel resistance" as measured by platelet function tests to adverse events. Additionally, the degree of clopidogrel-induced platelet inhibition appears to be a factor determining bleeding risk at coronary artery bypass grafting. A point-of-care device that could accurately and rapidly measure the degree of platelet inhibition among patients taking clopidogrel could be clinically valuable. Such a device would have the potential to allow therapeutic decision-making based on the degree of platelet inhibition, especially for patients undergoing percutaneous coronary intervention or coronary artery bypass grafting.
McLean
Dalton S
DS
Department of Medicine, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. dsmclean@partners.org
Cannon
Christopher P
CP