title: Latest clinical data on testing for high on-treatment platelet reactivity.
abstract: Antiplatelet therapy is the cornerstone of treatment for patients with acute coronary         syndromes and in those who are undergoing percutaneous coronary intervention (PCI).         Clopidogrel, a second-generation thienopyridine antiplatelet agent, is currently used to         prevent vascular complications in atherothrombotic patients, to prevent stent thrombosis         in patients undergoing PCI, and in the long-term prevention of cardiovascular and         cerebrovascular events. Unfortunately, despite treatment with clopidogrel, some patients         continue to have cardiovascular events. This may be due in part to a suboptimal         response to the drug, with minimal inhibition of platelet aggregation and/or high         on-treatment platelet reactivity. Point-of-care testing of clopidogrel response, together         with a reliable diagnostic cutoff, can identify patients with high on-treatment platelet         reactivity and optimize their clinical management. This article reviews the impact of         poor clopidogrel responsiveness on clinical outcomes, the major clinical studies using         VerifyNow P2Y12 Assay® (Accumetrics, San Diego, CA) to assess on-clopidogrel         platelet reactivity, and efforts to determine a reliable cutoff.
authors.affiliation: Cardiovascular Institute, Azienda Ospedaliero-Universitaria Sant'Anna, Ferrara, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Fileti
authors.forename: Gianluca
authors.initials: G
authors.lastname: Campo
authors.forename: Marco
authors.initials: M
authors.lastname: Valgimigli
mesh_terms: D002318:Cardiovascular Diseases / Q000097:blood / Q000188:drug therapy*; D000077144:Clopidogrel; D016903:Drug Monitoring / Q000379:methods*; D004351:Drug Resistance; D006801:Humans; D015539:Platelet Activation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D010979:Platelet Function Tests; D011237:Predictive Value of Tests; D058925:Receptors, Purinergic P2Y12 / Q000097:blood / Q000187:drug effects*; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: C548576:P2RY12 protein, human; D010975:Platelet Aggregation Inhibitors; D058925:Receptors, Purinergic P2Y12; D000077144:Clopidogrel; D013988:Ticlopidine