Platelet Function Assays—Not All Are Created Equal

[摘要] Platelet function testing has undergone major changes in the last decade. In the past, these tests were primarily used to diagnose hereditary bleeding disorders, typically using a platelet aggregation assay. Although diagnosis of bleeding disorders is still important, measuring platelet function to monitor platelet inhibitor therapy has become the more common reason for ordering this type of testing. This has also led to a variety of new platelet function assays designed to assist platelet inhibitor monitoring. It is now clear that many patients show resistance to platelet inhibitor therapy. These patients show less platelet inhibition than expected for a given dose of medication, and an increased risk of thrombosis. The most common forms of resistance are related to clopidogrel and aspirin therapy. Several different resistance mechanisms have been described, but the most common is reduced metabolism of clopidogrel to its active form, leading to inadequate platelet inhibition. Reduced absorption of medications and receptor polymorphisms leading to reduced binding and inhibition by these drugs has also been reported. Two approaches have been taken to assess …

[学科分类] 过敏症与临床免疫学