Platelet function tests and resistance to antiplatelet therapy.

Area of Science:

• Cardiovascular Medicine
• Pharmacology
• Clinical Laboratory Science

Background:

• Antiplatelet therapy is crucial for preventing arterial events in atherothrombotic disease.
• Despite established efficacy, a significant number of patients experience recurrent events.
• Patient non-compliance and
• resistance
• to antiplatelet drugs contribute to treatment failure.

Purpose of the Study:

• To review the current understanding of antiplatelet therapy resistance.
• To explore various laboratory methods for assessing platelet function and antiplatelet drug response.
• To discuss the potential clinical utility and limitations of routine monitoring.

Main Methods:

• Literature review of antiplatelet therapy, resistance mechanisms, and platelet function assays.
• Description of various ex vivo platelet function tests, including aggregometry, point-of-care devices, and biochemical markers.
• Discussion of the clinical implications and research gaps.

Main Results:

• Platelet function tests can identify inadequate platelet inhibition, a marker of potential resistance.
• Numerous assays exist, including light transmission aggregometry, PFA-100, VerifyNow, and flow cytometry.
• The clinical utility and cost-effectiveness of routine laboratory monitoring remain to be established.

Conclusions:

• While antiplatelet therapy is vital, resistance poses a clinical challenge.
• Laboratory monitoring offers a way to assess platelet inhibition but requires further validation.
• More research is needed to determine if routine monitoring improves clinical outcomes and is cost-effective.