The importance of anticoagulant agents in measuring platelet aggregation in patients treated with clopidogrel and aspirin.

摘要

Recent studies have demonstrated an association between the magnitude of post-treatment platelet reactivity and the occurrence of atherothrombotic events in patients undergoing percutaneous coronary intervention (PCI) [1,2]. Sodium citrate is the most commonly used anticoagulant when determining residual platelet reactivity in vitro, because it is widely available at low cost. However, sodium citrate chelates extracellular calcium, creating an artificial milieu that does not represent the in vivo situation. An alternative in vitro anticoagulant is D-phenylalanyl-L-propyl-L-arginine chloromethyl ketone (PPACK), which acts by inhibiting thrombin, thereby maintaining physiologic extracellular calcium levels [3].