Why have studies of tailored anti-platelet therapy failed so far?

Summary Published data linking clopidogrel non-responsiveness to adverse ischaemic events lead to the suggestion that the magnitude of platelet inhibition by clopidogrel can be monitored and individually adjusted. This has been tested in randomised clinical trials (ARCTIC, GRAVITAS and TRIGGER-PCI),...

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Bibliographic Details
Published in:Thrombosis and Haemostasis
Main Authors: Siller-Matula, Jolanta M., Jilma, Bernd
Format: Article in Journal/Newspaper
Language:English
Published: Georg Thieme Verlag KG 2013
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Online Access:http://dx.doi.org/10.1160/th13-03-0250
http://www.thieme-connect.de/products/ejournals/pdf/10.1160/TH13-03-0250.pdf
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Summary:Summary Published data linking clopidogrel non-responsiveness to adverse ischaemic events lead to the suggestion that the magnitude of platelet inhibition by clopidogrel can be monitored and individually adjusted. This has been tested in randomised clinical trials (ARCTIC, GRAVITAS and TRIGGER-PCI), but despite reducing platelet reactivity, a strategy of therapy adjustment based on platelet function monitoring did not reduce the incidence of cardiac ischaemic events. Several critical issues regarding the design of these trials, which might in part have led to negative results, are discussed in this article.