title: Why have studies of tailored anti-platelet therapy failed so far?
abstract: Published data linking clopidogrel non-responsiveness to adverse ischaemic events lead to the suggestion that the magnitude of platelet inhibition by clopidogrel can be monitored and individually adjusted. This has been tested in randomised clinical trials (ARCTIC, GRAVITAS and TRIGGER-PCI), but despite reducing platelet reactivity, a strategy of therapy adjustment based on platelet function monitoring did not reduce the incidence of cardiac ischaemic events. Several critical issues regarding the design of these trials, which might in part have led to negative results, are discussed in this article.
authors.affiliation: Jolanta Siller-Matula, MD, PhD, Department of Cardiology, Medical University of Vienna, Vienna, Austria, Tel.: +43 1 40 400 4614, Fax: +43 1 40 400 4216, E-mail: jolanta.siller-matula@meduniwien.ac.at.
authors.forename: Jolanta M
authors.initials: JM
authors.lastname: Siller-Matula
authors.forename: Bernd
authors.initials: B
authors.lastname: Jilma
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000601:surgery; D000077144:Clopidogrel; D004351:Drug Resistance; D006801:Humans; D007511:Ischemia / Q000209:etiology; D015539:Platelet Activation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D057285:Precision Medicine; D016032:Randomized Controlled Trials as Topic; D012107:Research Design / Q000592:standards*; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017211:Treatment Failure
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine