Does glycoprotein IIB/IIIA resistance exist?

[摘要] Platelet function testing is not embedded into routine clinical practice, because no optimal, easy, reproducible and multipathway platelet aggregation test can be accomplished in vitro. Only recently, the relationship between the level of platelet aggregation inhibition by platelet inhibitors and clinical outcome in acute myocardial infarction became more clear.1-5 High platelet reactivity was found in patients who experienced stent thrombosis, and patients with clopidogrel resistance were at increased risk of recurrent atherothrombotic events.1,2 Furthermore, in ST-elevation myocardial infarction (STEMI) increased levels of platelet aggregation were found compared with unstable angina or control patients.4 In a thrombolysis study, higher platelet receptor occupancy was coupled with better angiographic and electrocardiographic outcome.3 Finally, in STEMI patients undergoing primary percutaneous intervention (PCI), higher levels of platelet aggregation inhibition by abciximab were recently found to be associated with better myocardial reperfusion.5 Therefore, measuring platelet function in patients with an acute coronary artery syndrome is gaining interest to select patients at high risk of an unfavourable thrombotic event.

[学科分类] 心脏病和心血管学