title: Influence of platelet reactivity on clinical outcome of patients with stable coronary artery disease.
abstract: Single antiplatelet therapy with aspirin is actually recommended for cardiovascular prevention in patients with stable coronary disease, whereas dual antiplatelet therapy (aspirin and clopidogrel) represents the established treatment in patients with acute coronary syndromes or stable angina undergoing percutaneous coronary intervention. However, recurrent ischemic events occur in patients on treatment with clopidogrel; this may be due to low responsiveness to this agent, a phenomenon influenced by environmental, clinical, and genetic factors. Different strategies have been tested to overcome this phenomenon, such as increase in clopidogrel loading and maintenance doses and use of newer P2Y12 inhibitors (prasugrel and ticagrelor), which are by now indicated for patients with acute coronary syndromes; the latter agents have been associated with stronger antiplatelet effect than clopidogrel even in patients with stable coronary disease, but further studies are needed to test their net clinical benefit in this setting (reduction of ischemic events without increase in bleeding).
authors.affiliation: Department of Cardiovascular Sciences, Campus Bio-Medico University, Via E. Longoni, 83, 00155 Rome, Italy.
authors.forename: Annunziata
authors.initials: A
authors.lastname: Nusca
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Patti
authors.forename: Germano
authors.initials: G
authors.lastname: Di Sciascio
mesh_terms: D001792:Blood Platelets / Q000187:drug effects* / Q000378:metabolism; D003324:Coronary Artery Disease / Q000097:blood / Q000188:drug therapy*; D004351:Drug Resistance; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D010979:Platelet Function Tests; D011237:Predictive Value of Tests; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors