CLINICAL AND LABORATORY APPROACH OF RESISTANCE TO ANTIPLATELET TREATMENT

Abstract

Antiplatelet agents, aspirin and clopidogrel, have a crucial role in the treatment and prevention of cardiovascular events. Aspirin inhibits the cyclooxygenasedependent platelet function, whereas clopidogrel inhibits the P2Y12-adenosine diphosphate receptor. Various clinical and genetic factors involved in treatment resistance, which often affects the clinical outcome. Currently, the absence of standardized platelet function assays hampers the correlation between laboratory findings and clinical implications. Treatment approach includes the improvement of patient’s compliance, dose escalation and combined antiplateletet regimes. Several ongoing studies assess novel inhibitors of P2Y12 receptor, thrombin, thromboxane and platelet glycoprotein GPIIb/IIIa. This study is an overview of the clinical significance of antiplatelet resistance, examines the available platelet function tests; and presents their limitations in routine practice and the alternative treatment options