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March 16, 2011

An Initial Experiment With Personalized Antiplatelet TherapyThe GRAVITAS Trial

JAMA. 2011;305(11):1136-1137. doi:10.1001/jama.2011.332

The P2Y12 blockers play a critical role in preventing coronary thrombosis1 and are now widely used along with aspirin in patients undergoing coronary stent placement. Despite proven clinical efficacy, the antiplatelet effect of clopidogrel, the most widely used P2Y12 inhibitor, is highly variable as determined by ex vivo platelet function assays. Additionally, studies have demonstrated that high on-treatment platelet reactivity is a major cardiovascular risk factor for subsequent thrombotic events in patients treated with stents.2,3 This has led some to propose that patients who have received stents and were treated with clopidogrel should undergo on-treatment platelet function testing. Yet the degree to which such testing should guide therapy is not yet known.