{"title":"Resistance to antiplatelet drugs. Can it be assessed?","authors":"Rossella Marcucci","doi":"10.1016/j.ijcme.2014.10.012","DOIUrl":null,"url":null,"abstract":"<div><p>High platelet reactivity (HPR) during dual antiplatelet therapy is a marker of vascular risk, in particular stent thrombosis in patients with acute coronary syndromes. Genetic determinants (CYP2C19*2 polymorphism), advanced age, female gender, diabetes and reduced ventricular function are related to a higher risk to develop HPR. In addition, inflammation and increased platelet turnover, as revealed by the elevated percentage of reticulate platelets in patients' blood that characterize the acute phase of ACS, are associated with HPR. To overcome the limitation of Clopidogrel, new antiplatelet agents (Prasugrel and Ticagrelor) were synthesized and the demonstration of their superiority over Clopidogrel was obtained in two randomized trials TRITON TIMI 38 and PLATO. Due to the current possibility of choosing between multiple antiplatelet strategies, the future prospect is to include the definition of platelet function during treatment in order to set a tailored therapy, in addition to clinical data and classical risk factors.</p></div>","PeriodicalId":73333,"journal":{"name":"IJC metabolic & endocrine","volume":"8 ","pages":"Pages 31-33"},"PeriodicalIF":0.0000,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijcme.2014.10.012","citationCount":"3","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"IJC metabolic & endocrine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2214762414000541","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 3
Abstract
High platelet reactivity (HPR) during dual antiplatelet therapy is a marker of vascular risk, in particular stent thrombosis in patients with acute coronary syndromes. Genetic determinants (CYP2C19*2 polymorphism), advanced age, female gender, diabetes and reduced ventricular function are related to a higher risk to develop HPR. In addition, inflammation and increased platelet turnover, as revealed by the elevated percentage of reticulate platelets in patients' blood that characterize the acute phase of ACS, are associated with HPR. To overcome the limitation of Clopidogrel, new antiplatelet agents (Prasugrel and Ticagrelor) were synthesized and the demonstration of their superiority over Clopidogrel was obtained in two randomized trials TRITON TIMI 38 and PLATO. Due to the current possibility of choosing between multiple antiplatelet strategies, the future prospect is to include the definition of platelet function during treatment in order to set a tailored therapy, in addition to clinical data and classical risk factors.
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