title: Modern antiplatelet therapy - opportunities and risks.
abstract: Resistance to clopidogrel has been extensively investigated and described by researchers from many countries. Subsequent studies have contributed to a better understanding of the complex mechanisms in which clopidogrel is metabolised and have confirmed the negative effects on prognosis, both in a group of patients with low and excessive response to the drug. To prevent the dramatic consequences of an abnormal response to clopidogrel, 2 different strategies were adopted. The 1st employs the identification of patients based on platelet function tests, and genotyping and increasing the drug dose until the required aggregation parameters are achieved. The 2nd strategy is focused on developing new generation drugs whose efficacy will show fewer individual variations. So far diagnostic methods and tailored therapy have not been conclusively accepted for the treatment of patients, because novel pharmaceuticals have emerged providing more rapid action and beneficial effects, but without the disadvantages of clopidogrel. Still, there is a group of patients for whom clopidogrel remains the preferred choice, and considering the economic aspect, this drug can play a significant role in the treatment of many patients.
authors.affiliation: Wrovasc - Integrated Cardiovascular Centre, Regional Specialist Hospital in Wrocław, Research and Development Centre, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Protasiewicz
authors.forename: Paweł
authors.initials: P
authors.lastname: Szymkiewicz
authors.forename: Wiktor
authors.initials: W
authors.lastname: Kuliczkowski
authors.forename: Andrzej
authors.initials: A
authors.lastname: Mysiak
authors.forename: Wojciech
authors.initials: W
authors.lastname: Witkiewicz
mesh_terms: D000818:Animals; D000077144:Clopidogrel; D004351:Drug Resistance; D005820:Genetic Testing; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D010979:Platelet Function Tests; D012307:Risk Factors; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine