2013
DOI: 10.1136/heartjnl-2013-304461
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Tailored antiplatelet therapy and clinical adverse outcomes

Abstract: In the study, personalised antiplatelet treatment for antiplatelet resistance was found to be associated with less occurrence of death or stent thrombosis and the less risk of total clinical adverse events than conventional treatment, without increasing the risk of bleeding complications.

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Cited by 13 publications
(10 citation statements)
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“…Antiplatelet treatment guided by platelet function testing has been suggested. However, it is currently unclear whether administration of a more potent antiplatelet drug results in improved clinical outcomes in patients with HPR, at least in patients with acute coronary syndromes [2,[10][11][12].…”
Section: Discussionmentioning
confidence: 98%
“…Antiplatelet treatment guided by platelet function testing has been suggested. However, it is currently unclear whether administration of a more potent antiplatelet drug results in improved clinical outcomes in patients with HPR, at least in patients with acute coronary syndromes [2,[10][11][12].…”
Section: Discussionmentioning
confidence: 98%
“…Therefore, the combination of antiinflammatory therapies and conventional treatment (such as TACE) may improve the survival of patients with huge HCC and high PLR values. However, treatments targeting platelets remain difficult to apply because of potential adverse effects in overcoming normal platelet function [34,35]. To date, no specific platelet function targeted therapy has been included in standard HCC treatment regimens.…”
Section: Discussionmentioning
confidence: 99%
“…50 However, a recent meta-analysis of 9 pooled studies consisting of 12 048 subjects showed significant benefit for tailored versus standard antiplatelet therapy with a risk reduction of ≈60% without an increase in bleeding. 51 Smaller studies that demonstrated a consistent reduction in platelet reactivity in all patients below the threshold of high on-treatment platelet reactivity also showed significant clinical benefit of reduction in cardiovascular events. 50 Observational studies have suggested that CYP2C19 polymorphisms associated with reduced activation of clopidogrel increase the risk of thrombotic events by 2-fold in patients treated with clopidogrel.…”
Section: Aspirin and Clopidogrel Resistancementioning
confidence: 99%
“…51 Reasons for antiplatelet resistance include poor compliance, insufficient dose, slow pharmacodynamic effect, related gene polymorphisms that effect antiplatelet drug metabolism (eg, cytochrome P450 2C19 loss of function allele for clopidogrel biotransformation to active metabolite and ABCB1 polymorphisms, particularly 3435C>T, affecting efflux of clopidogrel via P-glycoprotein), 40 and PEAR1 variants in patients exposed to aspirin, 52 increased baseline platelet reactivity such as that found in diabetes mellitus and smoking, and increased platelet turnover. 40 Whatever the reason, predefined high on-treatment platelet reactivity is consistently associated with 2-to 4-fold increased risk of acute myocardial infarction, stent thrombosis, and stroke.…”
Section: Aspirin and Clopidogrel Resistancementioning
confidence: 99%