title: Current status of high on-treatment platelet reactivity in patients with coronary or peripheral arterial disease: Mechanisms, evaluation and clinical implications.
abstract: Antiplatelet therapy with aspirin or clopidogrel or both is the standard care for patients with proven coronary or peripheral arterial disease, especially those undergoing endovascular revascularization procedures. However, despite the administration of the antiplatelet regiments, some patients still experience recurrent cardiovascular ischemic events. So far, it is well documented by several studies that in vitro response of platelets may be extremely variable. Poor antiplatelet effect of clopidogrel or high on-treatment platelet reactivity (HTPR) is under investigation by numerous recent studies. This review article focuses on methods used for the ex vivo evaluation of HTPR, as well as on the possible underlying mechanisms and the clinical consequences of this entity. Alternative therapeutic options and future directions are also addressed.
authors.affiliation: Stavros Spiliopoulos, Georgios Pastromas, Department of Interventional Radiology, Patras University Hospital, 26504 Rio, Greece.
authors.forename: Stavros
authors.initials: S
authors.lastname: Spiliopoulos
authors.affiliation: Stavros Spiliopoulos, Georgios Pastromas, Department of Interventional Radiology, Patras University Hospital, 26504 Rio, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Pastromas
keywords: Antiplatelet therapy; Aspirin; Clopidogrel; Coronary disease; High on treatment platelet reactivity; Peripheral arterial disease; Prasugrel; Ticagrelor