Antiplatelet Drug Resistance
Antiplatelet drug therapy reduces vascular events in a wide range of patients. Although antiplatelet drug resistance is becoming well documented, a universal definition has not been established. This lack and the lack of standardized measures of platelet function make estimation of the prevalence of antiplatelet drug resistance difficult. Mounting evidence suggests that antiplatelet drug resistance is associated with adverse clinical outcomes, which have been assessed in patients with coronary artery disease, myocardial infarction, cerebrovascular disease, and peripheral vascular disease. Patients with antiplatelet drug resistance have significantly more vascular events than patients without such resistance. However, there are no guidelines for the treatment of antiplatelet drug resistance. Although point-of-care platelet-function testing makes screening for resistance feasible, routine screening should not be standard practice until data regarding the management of antiplatelet drug resistance are available.
Mounting evidence suggests that resistance to antiplatelet agents is clinically important. Positive correlations between biochemical antiplatelet drug resistance and adverse cardiovascular events have been established, although only in relatively small groups of selected patients. The definition of antiplatelet drug resistance largely depends on the method used to measure platelet function. As a result, no standard has been universally accepted. Mechanisms of antiplatelet drug resistance have been postulated, but none is clearly established as a cause of antiplatelet drug resistance in the clinical setting. In addition, we know of no data concerning the utility of treatment strategies in patients with antiplatelet drug resistance. Therefore, recommendations for the screening, diagnosis, and management of antiplatelet drug resistance have yet to be formulated.
Antiplatelet drug therapy reduces vascular events in a wide range of patients. Although antiplatelet drug resistance is becoming well documented, a universal definition has not been established. This lack and the lack of standardized measures of platelet function make estimation of the prevalence of antiplatelet drug resistance difficult. Mounting evidence suggests that antiplatelet drug resistance is associated with adverse clinical outcomes, which have been assessed in patients with coronary artery disease, myocardial infarction, cerebrovascular disease, and peripheral vascular disease. Patients with antiplatelet drug resistance have significantly more vascular events than patients without such resistance. However, there are no guidelines for the treatment of antiplatelet drug resistance. Although point-of-care platelet-function testing makes screening for resistance feasible, routine screening should not be standard practice until data regarding the management of antiplatelet drug resistance are available.
Mounting evidence suggests that resistance to antiplatelet agents is clinically important. Positive correlations between biochemical antiplatelet drug resistance and adverse cardiovascular events have been established, although only in relatively small groups of selected patients. The definition of antiplatelet drug resistance largely depends on the method used to measure platelet function. As a result, no standard has been universally accepted. Mechanisms of antiplatelet drug resistance have been postulated, but none is clearly established as a cause of antiplatelet drug resistance in the clinical setting. In addition, we know of no data concerning the utility of treatment strategies in patients with antiplatelet drug resistance. Therefore, recommendations for the screening, diagnosis, and management of antiplatelet drug resistance have yet to be formulated.
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