Anti-Platelet Drug Resistance

摘要

Laboratory aspirin unresponsiveness ("resistance") has been reported over the last 30 years, ranging between 5-50%, applying different methods, among individuals with a variety of cardiovascular disorders. From early works it has been realized that different methods give different results, depending on the end point of the tests. Thus results of testing plasma and urinary thrombaxane metabolites suggest a very low rate of laboratory resistance (LR) whereas platelet aggregation in response to arachidonic acid (AA) yields a relatively higher LR rate. Recently similar observation has been made regarding the response to clopidogrel as well. The main questions arising from these studies are:a) what are the mechanisms responsible for the LR phenomenon? b) does LR confer adverse clinical outcome? c) is there a way to overcome LR in an attempt to improve outcome? and d) what are the available methods suitable for testing aspirin and clopidogrel LR.