Antiplatelet resistance in stroke


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TOPÇUOĞLU M. A., ARSAVA E. M., Ay H.

EXPERT REVIEW OF NEUROTHERAPEUTICS, vol.11, no.2, pp.251-263, 2011 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Review
  • Volume: 11 Issue: 2
  • Publication Date: 2011
  • Doi Number: 10.1586/ern.10.203
  • Journal Name: EXPERT REVIEW OF NEUROTHERAPEUTICS
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.251-263
  • Keywords: antiplatelet, aspirin, clopidogrel, ischemic stroke, non-response, platelet function assay, point of care, resistance, stroke, LOW-DOSE ASPIRIN, CALCIUM-CHANNEL BLOCKERS, PLATELET-FUNCTION TESTS, PROTON PUMP INHIBITORS, PERCUTANEOUS CORONARY INTERVENTION, LIGHT TRANSMISSION AGGREGOMETRY, ISCHEMIC-STROKE, CARDIOVASCULAR EVENTS, LABORATORY EVALUATION, CLOPIDOGREL RESPONSE
  • Hacettepe University Affiliated: Yes

Abstract

Although the exact prevalence of antiplatelet resistance in ischemic stroke is not known, estimates about the two most widely used antiplatelet agents aspirin and clopidogrel suggest that the resistance rate is high, irrespective of the definition used and parameters measured. Inadequate antiplatelet responsiveness correlates with an increased risk of recurrent ischemic vascular events in patients with stroke and acute coronary syndrome. It is not currently known whether tailoring antiplatelet therapy based on platelet function test results translates into a more effective strategy to prevent secondary vascular events after stroke. Large-scale clinical trials using a universally accepted definition and standardized measurement techniques for antiplatelet resistance are needed to demonstrate whether a 'platelet-function test-guided antiplatelet treatment' strategy translates into improved stroke care. This article gives an overview of the clinical importance of laboratory antiplatelet resistance, describes the challenges for platelet-function test-guided antiplatelet treatment and discusses practical issues about the management of patients with aspirin and/or clopidogrel resistance.