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Antiplatelet Resistance-Does it Exist and How to Measure it?

S Saraf¹, I Bensalha, D A Gorog

¹Cardiology Department, East and North Hertfordshire NHS Trust, UK.

Clinical Medicine. Cardiology

|May 29, 2010

Summary

Resistance to aspirin and clopidogrel is a concern in coronary artery disease. New tests are needed to identify patients at risk and personalize antiplatelet therapy for better outcomes.

Keywords:

antiplatelet resistance

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Area of Science:

Cardiology
Pharmacology
Clinical Pathology

Background:

Aspirin and clopidogrel are standard antiplatelet therapies for coronary artery disease.
Patient resistance to these drugs poses a clinical challenge, impacting treatment efficacy.
Development of novel antiplatelet agents is ongoing to address resistance issues.

Purpose of the Study:

To review the evidence for antiplatelet resistance in laboratory and clinical settings.
To evaluate current diagnostic tests for antiplatelet resistance and their limitations.
To explore the potential for developing improved, clinically applicable tests for patient risk stratification.

Main Methods:

Review of existing literature on antiplatelet resistance and diagnostic methods.
Discussion of platelet function tests, including platelet aggregometry.
Analysis of the correlation between laboratory findings and clinical outcomes.

Main Results:

Evidence supports the existence of antiplatelet resistance in patients with coronary artery disease.
Platelet aggregometry, the current gold standard, is operator-dependent and shows limited correlation with other tests.
A need exists for simple, rapid, and affordable near-patient tests for clinical use.

Conclusions:

Antiplatelet resistance is a significant clinical issue in managing coronary artery disease.
Current gold-standard tests have limitations, hindering widespread clinical application.
Development of accessible point-of-care tests is crucial for risk stratification and personalized antiplatelet therapy.