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Microfluidics in Assessing Platelet Function
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The Platelet Activity After Clopidogrel Termination (PACT) study.

Andrew L Frelinger1, Marc R Barnard, Marsha L Fox

  • 1Center for Platelet Research Studies, Division of Hematology/Oncology, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115-5737, USA. andrew.frelinger@childrens.harvard.edu

Circulation. Cardiovascular Interventions
|August 26, 2010
PubMed
Summary
This summary is machine-generated.

Discontinuation of clopidogrel does not cause "rebound" platelet hyperreactivity. This study found no significant increase in platelet activity after stopping clopidogrel compared to placebo.

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Published on: December 7, 2012

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Hematology

Background:

  • The concept of
  • rebound
  • platelet hyperreactivity after clopidogrel cessation has been linked to increased thrombotic events, such as late stent thrombosis.
  • However, this hypothesis lacked rigorous scientific testing.

Purpose of the Study:

  • To investigate whether discontinuing clopidogrel leads to platelet hyperreactivity.
  • To rigorously test the
  • rebound
  • platelet hyperreactivity hypothesis.

Main Methods:

  • A randomized, double-blind, placebo-controlled, crossover study (PACT study) involving 15 healthy subjects.
  • Platelet reactivity was measured using various assays, including flow cytometry, light transmission aggregometry, and whole blood impedance aggregometry.
  • Measurements were taken at baseline, during treatment, and at multiple time points after discontinuing clopidogrel or placebo.

Main Results:

  • No significant increase in platelet reactivity was observed at any time point after clopidogrel discontinuation compared to placebo.
  • Immature platelet fraction also showed no significant changes post-clopidogrel cessation.

Conclusions:

  • The study demonstrates that discontinuing clopidogrel does not result in
  • rebound
  • platelet hyperreactivity.
  • These findings challenge the proposed link between clopidogrel cessation and increased thrombotic risk due to platelet hyperreactivity.