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DOI: 10.1055/s-0030-1255745
© Georg Thieme Verlag KG Stuttgart · New York
Verfahren zur Messung der Thrombozytenfunktion: pro und kontra
Publication History
Publication Date:
21 September 2010 (online)
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Abstract
Antiplatelet agents have been demonstrated to be beneficial in preventing atherothrombotic events among patients with atherosclerosis. However, antiplatelet drug response is variable and many patients present with inadequate platelet inhibition leading to an increased risk for ischemic events despite state-of-the-art therapy. Several tests for assessing platelet function are currently available, but none of them has been found most suitable for clinical routine to monitor antiplatelet therapy and predict clinical outcome. In this article we aim to give a review on tests currently available and discuss advantages and drawbacks for routine clinical use.
Literatur
- 1 Steinhubl S R, Berger P B, Mann 3rd J T. et al . Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial. JAMA. 2002; 288 2411-2420
- 2 Mehta S R, Yusuf S, Peters R J. et al . Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet. 2001; 358 527-533
- 3 Geisler T, Kapp M, Göhring-Frischholz K. et al . Residual platelet activity is increased in clopidogrel- and ASA-treated patients with coronary stenting for acute coronary syndromes compared with stable coronary artery disease. Heart. 2008; 94 743-747
- 4 Geisler T, Zürn C, Simonenko R. et al . Early but not late stent thrombosis is influenced by residual platelet aggregation in patients undergoing coronary interventions. Eur Heart J. 2010; 31 59-66
- 5 Braunwald E, Angiolillo D, Bates E. et al . Assessing the current role of platelet function testing. Clin Cardiol. 2008; 31 I10-I16
- 6 Geisler T, Langer H, Wydymus M. et al . Low response to clopidogrel is associated with cardiovascular outcome after coronary stent implantation. Eur Heart J. 2006; 27 2420-2425
- 7 Matetzky S, Shenkman B, Guetta V. et al . Clopidogrel resistance is associated with increased risk of recurrent atherothrombotic events in patients with acute myocardial infarction. Circulation. 2004; 29 3171-3175
- 8 Hochholzer W, Trenk D, Bestehorn H P. et al . Impact of the degree of peri-interventional platelet inhibition after loading with clopidogrel on early clinical outcome of elective coronary stent placement. J Am Coll Cardiol. 2006; 48 1742-1750
- 9 Breet N J, van Werkum J W, Bouman H J. et al . Comparison of platelet function tests in predicting clinical outcome in patients undergoing coronary stent implantation. JAMA. 2010; 303 754-762
- 10 Sibbing D, Braun S, Morath T. et al . Platelet reactivity after clopidogrel treatment assessed with point-of-care analysis and early drug-eluting stent thrombosis. J Am Coll Cardiol. 2009; 53 849-856
- 11 Sibbing D, Braun S, Jawansky S. et al . Assessment of ADP-induced platelet aggregation with light transmission aggregometry and multiple electrode platelet aggregometry before and after clopidogrel treatment. Thromb Haemost. 2008; 99 121-126
- 12 Frere C, Cuisset T, Quilici J. et al . ADP-induced platelet aggregation and platelet reactivity index VASP are good predictive markers for clinical outcomes in non-ST elevation acute coronary syndrome. Thromb Haemost. 2007; 98 838-843
- 13 Bonello L, Paganelli F, Arpin-Bornet M. et al . Vasodilator-stimulated phosphoprotein phosphorylation analysis prior to percutaneous coronary intervention for exclusion of postprocedural major adverse cardiovascular events. J Thromb Haemost. 2007; 5 1630-1636
- 14 Shah U, Ma A D. Tests of platelet function. Curr Opin Hematol. 2007; 14 432-437
- 15 van Werkum J W, Bouman H J, Breet N J. et al . The Cone-and-Plate(let) analyzer is not suitable to monitor clopidogrel therapy: a comparison with the flowcytometric VASP assay and optical aggregometry. Thromb Res. 2010; 126 44-49
- 16 Favaloro E J. Clinical utility of the PFA-100. Semin Thromb Hemost. 2008; 34 709-733
- 17 Paniccia R, Antonucci E, Gori A M. et al . Different methodologies for evaluating the effect of clopidogrel on platelet function in high-risk coronary artery disease patients. J Thromb Haemost. 2007; 5 1839-1847
- 18 Bliden K P, DiChiara J, Tantry U S. et al . Increased risk in patients with high platelet aggregation receiving chronic clopidogrel therapy undergoing percutaneous coronary intervention: is the current antiplatelet therapy adequate?. J Am Coll Cardiol. 2007; 49 657-666
- 19 Smith Jr. S C, Feldman T E, Hirshfeld Jr. J W. et al . ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update 2001 Guidelines for Percutaneous Coronary Intervention). Circulation. 2006; 113 e166-e286
Mario Herkommer
Universitätsklinikum Tübingen
Medizinische Klinik und Poliklinik
Abteilung Innere Medizin III/Kardiologie und Kreislauferkrankungen
Otfried-Müller-Straße 10
72076 Tübingen
Email: mario.herkommer@med.uni-tuebingen.de