Modern antiplatelet therapy - opportunities and risks.

Area of Science:

• Pharmacology
• Cardiovascular Medicine
• Clinical Pharmacy

Background:

• Clopidogrel resistance is a significant clinical issue affecting patient outcomes.
• Understanding clopidogrel metabolism is crucial for managing antiplatelet therapy.
• Both low and excessive responses to clopidogrel negatively impact prognosis.

Purpose of the Study:

• To review the mechanisms and clinical implications of clopidogrel resistance.
• To discuss current strategies for managing abnormal clopidogrel response.
• To evaluate the role of clopidogrel in light of newer antiplatelet agents.

Main Methods:

• Literature review of studies on clopidogrel metabolism and resistance.
• Analysis of diagnostic approaches, including platelet function tests and genotyping.
• Evaluation of therapeutic strategies: dose adjustment and development of new drugs.

Main Results:

• Variable clopidogrel metabolism leads to unpredictable patient responses.
• Current diagnostic and tailored therapy approaches are not universally adopted.
• Newer antiplatelet drugs offer advantages but clopidogrel remains a viable option for some patients.

Conclusions:

• Managing clopidogrel resistance requires personalized treatment strategies.
• While novel drugs are emerging, clopidogrel's cost-effectiveness ensures its continued relevance.
• Further research is needed to optimize antiplatelet therapy for all patients.