Platelet function variability and non-genetic causes.
Summary of "Platelet function variability and non-genetic causes."
Dual antiplatelet therapy (DAPT) has been established for the treatment of coronary artery disease, especially in and after acute coronary syndromes, and after coronary interventions. Data suggest that a significant percentage of individuals treated with clopidogrel do not receive the expected therapeutic benefit because of a decreased responsiveness of their platelets, which is caused by several extrinsic and intrinsic mechanisms. The clinical consequence of clopidogrel non-responsiveness is severe cardiovascular complications. Besides genetic variability in response to antiplatelet therapy, non-genetic causes such as drug interactions (proton-pump inhibitors, statins, calcium-channel blockers, coumarine derivates, antibiotics, antimycotics) and co-morbidities (diabetes mellitus, renal failure, obesity) are responsible for this phenomenon. Large clinical trials with standardised laboratory methods and hard clinical endpoints are needed to identify these interactions with clopidogrel and predictors for its non-responsiveness.
Affiliation
Prof. Dr. Kurt Huber, 3rd Department of Medicine, Cardiology and Emergency Medicine, Wilhelminenhospital, Montleartstrasse 37, A-1160 Vienna, Austria, Tel.: +43 1 49150 2301, Fax: +43 1 49150 2309, E-mail: kurt.huber@wienkav.at.
Journal Details
This article was published in the following journal.
Name: Thrombosis and haemostasis
ISSN: 0340-6245
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21491057
- DOI: http://dx.doi.org/10.1160/THS11-01-0025
Medical and Biotech [MESH] Definitions
Blood Platelet Disorders
Disorders caused by abnormalities in platelet count or function.
Clot Retraction
Retraction of a clot resulting from contraction of PLATELET pseudopods attached to FIBRIN strands. The retraction is dependent on the contractile protein thrombosthenin. Clot retraction is used as a measure of platelet function.
Gray Platelet Syndrome
A rare, inherited platelet disorder characterized by a selective deficiency in the number and contents of platelet alpha-granules. It is associated with THROMBOCYTOPENIA, enlarged platelets, and prolonged bleeding time.
Recombination, Genetic
Production of new arrangements of DNA by various mechanisms such as assortment and segregation, CROSSING OVER; GENE CONVERSION; GENETIC TRANSFORMATION; GENETIC CONJUGATION; GENETIC TRANSDUCTION; or mixed infection of viruses.
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