Comparison of current platelet functional tests for the assessment of aspirin and clopidogrel response

Sandra Le Quellec; Jean-Claude Bordet; Claude Negrier; Yesim Dargaud

doi:10.1160/TH15-11-0870

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2016; 116(04): 638-650
DOI: 10.1160/TH15-11-0870

Review Article

Schattauer GmbH

Comparison of current platelet functional tests for the assessment of aspirin and clopidogrel response

A review of the literature

Sandra Le Quellec

¹Laboratoire d’hematologie Grand Est, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Bron, France

²Unité d’hémostase Clinique, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, Bron, France

,

Jean-Claude Bordet

¹Laboratoire d’hematologie Grand Est, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Bron, France

,

Claude Negrier

¹Laboratoire d’hematologie Grand Est, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Bron, France

²Unité d’hémostase Clinique, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, Bron, France

,

Yesim Dargaud

¹Laboratoire d’hematologie Grand Est, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Bron, France

²Unité d’hémostase Clinique, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, Bron, France

› Author Affiliations

Abstract

Summary

The two most widely used antiplatelet drugs in the world are aspirin and clopidogrel. However, some patients on aspirin and/or clopidogrel therapy do not respond appropriately to either aspirin or clopidogrel. This phenomenon is usually called “aspirin/clopidogrel resistance”. Several platelet function tests have been used in various studies for the assessment of aspirin and clopidogrel resistance in healthy individuals and patients admitted in cardiology departments. An accurate assessment of platelet response to aspirin/clopidogrel could benefit patients by proposing tailored-antiplatelet therapy based on test results. However, there is a clear lack of standardisation of such techniques and their analytical variability may induce misinterpretation. After a quick report of the mechanisms responsible for aspirin/clopidogrel resistance, we describe the pre-analytical aspects and the analytical performances of current platelet function tests (Light-transmission aggregometry, whole-blood aggregometry, VerifyNow®, Platelet Function Analyzer®, thromboelastography, VASP assay) that are used for the assessment of aspirin/clopidogrel resistance in clinical studies. Considering the different variables that have to be taken into account with each of the platelet function tests, a particular attention should be paid when interpreting results.

Keywords

Antiplatelet agents - aspirin resistance - clopidogrel resistance - platelet function test - aggregometry

Full Text

References

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