How I use laboratory monitoring of antiplatelet therapy

Area of Science:

• Cardiovascular Medicine
• Hematology

Background:

• Antiplatelet therapy is crucial for managing coronary artery disease and other conditions.
• Aspirin and clopidogrel are widely used antiplatelet agents.
• The concept of 'resistance' to these drugs is a common clinical concern.

Observation:

• This review examines platelet function, drug targets, and clinical uses of antiplatelet agents.
• It addresses the question of patient resistance to aspirin and clopidogrel.
• The article analyzes whether platelet function tests should guide therapy, considering two clinical cases.

Findings:

• Available evidence does not support using laboratory tests to guide aspirin or clopidogrel dosage in patients with apparent resistance.
• The clinical benefit of tailoring antiplatelet therapy based on resistance testing remains controversial.

Implications:

• Current guidelines and evidence do not endorse routine platelet function testing for dose adjustment of aspirin or clopidogrel.
• Further research may be needed to clarify the role and clinical utility of antiplatelet resistance testing.