Related Experiment Video
Updated: May 9, 2026
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
High on-treatment platelet reactivity in peripheral endovascular procedures
Stavros Spiliopoulos1, George Kassimis, Adam Hatzidakis
1Department of Radiology, Patras University Hospital, Rio, Greece.
Insights
High on-treatment platelet reactivity (HTPR) despite dual-antiplatelet therapy is common in peripheral arterial disease (PAD). New antiplatelet strategies are needed to improve outcomes after angioplasty and stent deployment in PAD patients.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Interventional Cardiology
Background:
- Aspirin is standard for cardiovascular event reduction in atherosclerosis, including peripheral arterial disease (PAD).
- Dual-antiplatelet therapy (DAPT) with aspirin and clopidogrel is standard post-angioplasty/stent in PAD.
- Despite DAPT, significant adverse cardiovascular events persist in PAD patients.
Purpose of the Study:
- To review the prevalence, etiology, and clinical impact of high on-treatment platelet reactivity (HTPR) in PAD.
- To explore novel antiplatelet regimens for PAD management.
Main Methods:
- Literature review of studies on HTPR in PAD patients.
- Analysis of current evidence on antiplatelet efficacy and resistance.
- Discussion of emerging therapeutic strategies.
Main Results:
- High on-treatment platelet reactivity (HTPR) is a recognized phenomenon in PAD patients on DAPT.
- HTPR contributes to recurrent adverse cardiovascular events.
- Current antiplatelet therapies may not achieve sufficient platelet inhibition in all PAD patients.
Conclusions:
- HTPR is a significant challenge in managing PAD patients undergoing percutaneous intervention.
- Enhanced platelet inhibition is a therapeutic goal for improving outcomes in PAD.
- Novel antiplatelet agents and treatment strategies warrant further investigation for PAD.
Abstract:
The use of aspirin is considered the "gold standard" for the decrease of major adverse cardiovascular events in patients with atherosclerosis, including peripheral arterial disease (PAD), whereas a dual-antiplatelet regimen with aspirin and clopidogrel is usually indicated for such patients after angioplasty and stent deployment. However, a substantial number of subsequent adverse events still occur, even in patients who receive double-antiplatelet therapy. The "high on-treatment platelet reactivity" (HTPR) phenomenon has been lately recognized and plays a major role in the management of patients with PAD. Greater and more rapid inhibition of platelet aggregation has become the goal for new antiplatelet agents with the expectation of further improving outcomes for percutaneous intervention for PAD. The purpose of this review article is to highlight current evidence regarding the prevalence, aetiology, and clinical implications of HTPR in PAD as well as to discuss the possibilities of novel alternative antiplatelet regiments.
More Related Videos
Related Concept Videos
01:22Formation of the Platelet Plug
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
01:27Peripheral Artery Disease III: Interprofessional Care
01:05Introduction to Hemostasis
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized, and...