title: Comparison of current platelet functional tests for the assessment of aspirin and clopidogrel response. A review of the literature.
abstract: The two most widely used antiplatelet drugs in the world are aspirin and clopidogrel. However, some patients on aspirin and/or clopidogrel therapy do not respond appropriately to either aspirin or clopidogrel. This phenomenon is usually called "aspirin/clopidogrel resistance". Several platelet function tests have been used in various studies for the assessment of aspirin and clopidogrel resistance in healthy individuals and patients admitted in cardiology departments. An accurate assessment of platelet response to aspirin/clopidogrel could benefit patients by proposing tailored-antiplatelet therapy based on test results. However, there is a clear lack of standardisation of such techniques and their analytical variability may induce misinterpretation. After a quick report of the mechanisms responsible for aspirin/clopidogrel resistance, we describe the pre-analytical aspects and the analytical performances of current platelet function tests (Light-transmission aggregometry, whole-blood aggregometry, VerifyNow®, Platelet Function Analyzer®, thromboelastography, VASP assay) that are used for the assessment of aspirin/clopidogrel resistance in clinical studies. Considering the different variables that have to be taken into account with each of the platelet function tests, a particular attention should be paid when interpreting results.
authors.affiliation: Sandra Le Quellec, Unité d'hémostase clinique, Université Lyon I-Hospices Civils de Lyon, 59 Boulevard Pinel, 69677 Bron, France, Tel.: +33 472118810, Fax: +33 472118817, E-mail: sandra.le-quellec@chu-lyon.fr.
authors.forename: Sandra
authors.initials: S
authors.lastname: Le Quellec
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Bordet
authors.forename: Claude
authors.initials: C
authors.lastname: Negrier
authors.forename: Yesim
authors.initials: Y
authors.lastname: Dargaud
mesh_terms: D001241:Aspirin / Q000627:therapeutic use*; D001792:Blood Platelets / Q000187:drug effects*; D000077144:Clopidogrel; D006801:Humans; D010974:Platelet Aggregation; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D010979:Platelet Function Tests; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin
keywords: Antiplatelet agents; aggregometry; aspirin resistance; clopidogrel resistance; platelet function test