Platelet monitoring for PCI

Summary

Despite the clinical benefit associated with the combined use of aspirin and clopidogrel in patients with acute coronary syndrome or those undergoing percutaneous coronary intervention, a considerable interindividual variability in response to these drugs have been consistently reported. There is a growing interest on applying platelet functional tests with the goal of identifying patients at increased risk of recurrent ischaemic events and potentially tailoring antiplatelet treatment regimens.

This manuscript will review the state of the art on the most commonly available platelet functional tests, describing their advantages and disadvantages and exploring their applicability in clinical practice.

Keywords

Platelet functional test - percutaneous coronary intervention - platelets

• References

• 1 King 3^rd SB, Smith Jr SC, Hirshfeld Jr JW. et al. 2007 Focused Update of the 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. Circulation 2008; 117: 261-295.
• 2 Anderson JL, Adams CD, Antman EM. et al. ACC/ AHA 2007 guidelines for the management of patients with unstable angina/non ST-elevation myocardial infarction. Circulation 2007; 116: e148-304.
• 3 Angiolillo DJ, Fernandez-Ortiz A, Bernardo E. et al. Variability in individual responsiveness to clopidogrel: clinical implications, management, and future perspectives. J Am Coll Cardiol 2007; 49: 1505-1516.
• 4 Angiolillo DJ. Variability in responsiveness to oral antiplatelet therapy. Am J Cardiol. 2009; 103: 27A-34A.
• 5 Ferreiro JL, Angiolillo DJ. Clopidogrel response variability: Current status and future directions. Thromb Haemost 2009; 102: 7-14.
• 6 Alfonso F, Angiolillo DJ. Platelet function assessment to predict outcomes after coronary interventions: Hype or hope?. J Am Coll Cardiol 2006; 48: 1751-1754.
• 7 Angiolillo DJ. Platelet function testing in clinical practice: are we ready for prime time?. Rev Esp Cardiol 2009; 62: 113-116.
• 8 Angiolillo DJ, Alfonso F. Platelet function testing and cardiovascular outcomes: Steps forward in identifying the best predictive measure. Thromb Haemost 2007; 98: 707-709.
• 9 Michelson AD. Methods for the measurement of platelet function. Am J Cardiol 2009; 103: 20A-26A.
• 10 Michelson AD, Frelinger AL, Furman MI. Current options in platelet function testing. Am J Cardiol 2006; 98: 4N-10N.
• 11 Gonzalez-Conejero R, Rivera J, Corral J. et al. Biological assessment of aspirin efficacy on healthy individuals: heterogeneous response or aspirin failure?. Stroke 2005; 36: 276-280.
• 12 Catella F, Healy D, Lawson JA, FitzGerald GA. 11-Dehydrothromboxane B2: a quantitative index of thromboxane A2 formation in the human circulation. Proc Natl Acad Sci USA 1986; 83: 5861-5865.
• 13 Born GV. Aggregation of blood platelets by adeno-sine diphosphate and its reversal. Nature 1962; 194: 927-929.
• 14 O’Brien JR. Platelet aggregation. Part II: some results of a new method. J Clin Pathol 1962; 15: 452-455.
• 15 Latimer P. Blood platelet aggregometer: predicted effects of aggregation, photometer geometry, and multiple scattering. Appl Opt 1983; 22: 1136.
• 16 Von Beckerath N, Pogatsa-Murray G, Wieczorek A. et al. Correlation of a new point-of-care test with conventional optical aggregometry for the assessment of clopidogrel responsiveness. Thromb Haemost 2006; 95: 910-911.
• 17 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.
• 18 Campbell J, Ridgway H, Carville D. Plateletworks: a novel point of care platelet function screen. Mol Diagn Ther 2008; 12: 253-258.
• 19 Angiolillo DJ, Capranzano P, Desai B. et al. Impact of P2Y(12) inhibitory effects induced by clopidogrel on platelet procoagulant activity in type 2 diabetes mellitus patients. Thromb Res 2009; 124: 318-322.
• 20 Favaloro EJ. Clinical utility of the PFA-100. Semin Thromb Hemost 2008; 34: 709-733.
• 21 Velik-Salchner C, Maier S, Innerhofer P. et al. Point-of-care whole blood impedance aggregometry versus classical light transmission aggregometry for detecting aspirin and clopidogrel: the results of a pilot study. Anesth Analg 2008; 107: 1798-1806.
• 22 Dyszkiewicz-Korpanty A, Olteanu H, Frenkel EP, Sarode R. Clopidogrel anti-platelet effect: an evaluation by optical aggregometry, impedance aggregometry, and the platelet function analyzer (PFA-100). Platelets 2007; 18: 491-496.
• 23 Lordkipanidzé M, Pharand C, Nguyen TA. et al. Comparison of four tests to assess inhibition of platelet function by clopidogrel in stable coronary artery disease patients. Eur Heart J 200 29: 2877-2885.
• 24 Lordkipanidzé M, Pharand C, Schampaert E. et al. Evaluation of the platelet count drop method for assessment of platelet function in comparison with ,,gold standard“ light transmission aggregometry. Thromb Res 2009; 124: 418-422.
• 25 Gori AM, Marcucci R, Paniccia R. et al. Thrombotic events in high risk patients are predicted by evaluating different pathways of platelet function. Thromb Haemost 2008; 100: 1136-1145.
• 26 Smith Jr SC, Feldman TE, Hirshfeld Jr JW. et al. ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention. Circulation 2006; 113: e166-286.
• 27 Bonello L, Camoin-Jau L, Arques S. et al. Adjusted clopidogrel loading doses according to vasodilator-stimulated phosphoprotein phosphorylation index decrease rate of major adverse cardiovascular events in patients with clopidogrel resistance: a multicenter randomized prospective study. J Am Coll Cardiol 2008; 51: 1404-1411.
• 28 Bonello L, Camoin-Jau L, Armero S. et al. Tailored clopidogrel loading dose according to platelet reactivity monitoring to prevent acute and subacute stent thrombosis. Am J Cardiol 2009; 103: 5-10.
• 29 Valgimigli M, Campo G, de Cesare N. et al. Tailoring Treatment With Tirofiban in Patients Showing Resistance to Aspirin and/or Resistance to Clopidogrel (3T/2R) Investigators. Intensifying platelet inhibition with tirofiban in poor responders to aspirin, clopidogrel, or both agents undergoing elective coronary intervention. Circulation 2009; 119: 3215-3222.
• 30 Cuisset T, Frere C, Quilici J. et al. Glycoprotein IIb/ IIIa inhibitors improve outcome after coronary stenting in clopidogrel nonresponders: a prospective, randomized study. J Am Coll Cardiol Intv 2008; 1: 649-653.
• 31 Angiolillo DJ, Shoemaker SB, Desai B. et al. Randomized comparison of a high clopidogrel maintenance dose in patients with diabetes mellitus and coronary artery disease: results of the Optimizing Antiplatelet Therapy in Diabetes Mellitus (OPTIMUS) study. Circulation 2007; 115: 708-716.
• 32 Price MJ, Berger PB, Angiolillo DJ. et al. Evaluation of individualized clopidogrel therapy after drug-eluting stent implantation in patients with high residual platelet reactivity: design and rationale of the GRAVITAS trial. Am Heart J 2009; 157: 818-824.
• 33 Lee SW, Park SW, Hong MK. et al. Triple versus dual antiplatelet therapy after coronary stenting: impact on stent thrombosis. J Am Coll Cardiol 2005; 46: 1833-1837.
• 34 Angiolillo DJ, Capranzano P, Goto S. et al. A randomized study assessing the impact of cilostazol on platelet function profiles in patients with diabetes mellitus and coronary artery disease on dual anti-platelet therapy: results of the OPTIMUS-2 study. Eur Heart J 2008; 29: 2202-2211.
• 35 Biondi-Zoccai GG, Lotrionte M, Anselmino M. et al. Systematic review and meta-analysis of randomized clinical trials appraising the impact of cilostazol after percutaneous coronary intervention. Am Heart J 2008; 155: 1081-1089.
• 36 Pettersen AA, Seljeflot I, Abdelnoor M, Arnesen H. Unstable angina, stroke, myocardial infarction and death in aspirin non-responders. A prospective, randomized trial. The ASCET (ASpirin non-responsiveness and Clopidogrel Endpoint Trial) design. Scand Cardiovasc J 2004; 38: 353-356.
• 37 Angiolillo DJ, Bhatt DL, Gurbel PA, Jennings LK. Advances in antiplatelet therapy: agents in clinical development. Am J Cardiol 2009; 103: 40A-51A.
• 38 Marin F, Gonzalez-Conejero R, Capranzano P. et al. Pharmacogenetics in cardiovascular antithrombotic therapy. J Am Coll Cardiol 2009; 54: 1041-1057.