title: Update: Acute coronary syndromes (V). Personalized antiplatelet therapy.
abstract: It is well established that high on-treatment platelet reactivity to adenosine diphosphate during clopidogrel therapy is an independent risk factor for ischemic event occurrences in a postpercutaneous coronary intervention patients. However, the precise role of platelet function testing remains debated. Platelet function testing to ensure optimal platelet inhibition has been recommended by some authorities to improve outcomes in patients treated with clopidogrel. Recent prospective, randomized trials of personalized antiplatelet therapy have failed to demonstrate a benefit of platelet function testing in improving outcomes. In this review article, we discuss the mechanisms responsible for clopidogrel nonreponsiveness, recent trials of platelet function testing, and other new developments in the field of personalized antiplatelet therapy.
authors.affiliation: Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, Baltimore, Maryland, United States. Electronic address: pgurbel@lifebridgehealth.org.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Gurbel
authors.affiliation: Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, Baltimore, Maryland, United States.
authors.forename: Rahil
authors.initials: R
authors.lastname: Rafeedheen
authors.affiliation: Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, Baltimore, Maryland, United States.
authors.forename: Udaya S
authors.initials: US
authors.lastname: Tantry
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D000077144:Clopidogrel; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D057285:Precision Medicine; D016032:Randomized Controlled Trials as Topic; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D017211:Treatment Failure
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine
keywords: Determinación de genotipo; Genotyping; Personalized antiplatelet therapy; Platelet function testing; Pruebas de la función plaquetaria; Thrombosis; Tratamiento antiagregante plaquetario personalizado; Trombosis