September 21, 2011

Applying Platelet Function Testing in Clinical PracticeWhat Are the Unmet Needs?

Author Affiliations

Author Affiliation: University of Florida College of Medicine–Jacksonville.

JAMA. 2011;306(11):1260-1261. doi:10.1001/jama.2011.1349

Clopidogrel is the most widely prescribed platelet P2Y12 receptor inhibitor and is recommended, in addition to aspirin, for prevention of atherothrombotic recurrences in patients with acute coronary syndromes (ACS) and for those undergoing percutaneous coronary interventions (PCI). Despite the proven efficacy of clopidogrel for patients in these high-risk settings, studies of platelet function testing (PFT) have shown broad variability in interindividual response to this pivotal antiplatelet agent.1 Importantly, PFT has prognostic implications because patients with high residual platelet reactivity (HRPR) vs low residual platelet reactivity (LRPR) have increased risks of ischemic and bleeding complications, respectively.2,3 These observations have led to investigations aimed at defining the best platelet function test and cutoff values to predict adverse outcomes as well as treatment strategies associated with optimized levels of platelet inhibitory effects; the ultimate goal is to minimize ischemic and bleeding complications.13

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