Platelet function testing in atherothrombotic disease.
Platelet function testing was introduced more than a century ago with the invention of bleeding time; a test which has now been replaced by more accurate methods. Light transmittance aggregometry is traditionally regarded as the gold standard for evaluating platelet function. However, lately the position of light transmittance aggregometry has been challenged by a panel of new instruments. Aspirin and P2Y12-inhibitors are antiplatelet drugs used for secondary prevention of cardiovascular disease. However, an increasing recognition of the fact that not all patients respond adequately to these agents has prompted a focus on individualising antiplatelet treatment. Platelet function testing enables the detection of patients with high on-treatment platelet reactivity and facilitates individually tailored antiplatelet therapy, yet platelet function tests have still not been adopted into routine clinical practice. The present review outlines key milestones of the development of platelet function testing and provides an up-to-date overview of currently available tests and important studies evaluating their strengths and limitations in a clinical context.
Department of Cardiology, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200 Aarhus, Denmark. erikgrove@dadlnet.dk
Erik Lerkevang
EL
Grove
Robert F
RF
Storey
Morten
M
Würtz
D001241:Aspirin / Q000627:therapeutic use; D050197:Atherosclerosis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D001792:Blood Platelets / Q000187:drug effects / Q000378:metabolism*; D015815:Cell Adhesion Molecules / Q000097:blood; D004351:Drug Resistance; D006801:Humans; D008840:Microfilament Proteins / Q000097:blood; D018579:Patient Selection; D010750:Phosphoproteins / Q000097:blood; D010766:Phosphorylation; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D010979:Platelet Function Tests; D011237:Predictive Value of Tests; D058921:Purinergic P2Y Receptor Antagonists / Q000627:therapeutic use; D058925:Receptors, Purinergic P2Y12 / Q000097:blood / Q000187:drug effects; D013927:Thrombosis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D016896:Treatment Outcome; D000098662:Vasodilator-Stimulated Phosphoprotein
D015415:Biomarkers; D015815:Cell Adhesion Molecules; D008840:Microfilament Proteins; C548576:P2RY12 protein, human; D010750:Phosphoproteins; D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D058925:Receptors, Purinergic P2Y12; D000098662:Vasodilator-Stimulated Phosphoprotein; D001241:Aspirin