Bedside Monitoring to Adjust Antiplatelet Therapy for Coronary Stenting

In this trial, bedside platelet-function monitoring to adjust antiplatelet therapy after coronary stent implantation did not reduce the rate of subsequent cardiovascular events, a finding that calls into question the clinical value of this type of testing. Clopidogrel and aspirin play a central role...

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Vydané v:The New England journal of medicine Ročník 367; číslo 22; s. 2100 - 2109
Hlavní autori: Collet, Jean-Philippe, Cuisset, Thomas, Rangé, Grégoire, Cayla, Guillaume, Elhadad, Simon, Pouillot, Christophe, Henry, Patrick, Motreff, Pascal, Carrié, Didier, Boueri, Ziad, Belle, Loic, Van Belle, Eric, Rousseau, Hélène, Aubry, Pierre, Monségu, Jacques, Sabouret, Pierre, O'Connor, Stephen A, Abtan, Jérémie, Kerneis, Mathieu, Saint-Etienne, Christophe, Barthélémy, Olivier, Beygui, Farzin, Silvain, Johanne, Vicaut, Eric, Montalescot, Gilles
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Waltham, MA Massachusetts Medical Society 29.11.2012
Predmet:
Acute coronary syndromes
Aged
Antiplatelet therapy
Aspirin
Aspirin - administration & dosage
Biological and medical sciences
Cardiology. Vascular system
Catheterization
Cerebral infarction
Clinical trials
Clopidogrel
Coronary Disease - mortality
Coronary Disease - therapy
Coronary heart disease
Coronary Thrombosis
Diseases of the cardiovascular system
Drug dosages
Drug Monitoring - methods
Drug therapy
Female
General aspects
Heart
Heart attacks
Humans
Implants
Male
Medical sciences
Middle Aged
Myocardial infarction
Myocardial Infarction - epidemiology
Patients
Piperazines - administration & dosage
Platelet Aggregation Inhibitors - administration & dosage
Platelets
Point-of-Care Systems
Prasugrel Hydrochloride
Pyridines - administration & dosage
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Retreatment
Stents
Stents - adverse effects
Stroke
Thiophenes - administration & dosage
Thrombosis
Ticlopidine - administration & dosage
Ticlopidine - analogs & derivatives
France
Bed
Endoprosthesis
Point-of-care testing
Angioplasty
Coronary artery
Instrumentation therapy
Cardiovascular disease
Patient
Coronary heart disease
Stent
Antiplatelet agent
Medicine
Chemotherapy
Treatment
Surveillance
Point of care testing
ISSN:0028-4793, 1533-4406, 1533-4406
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Shrnutí:In this trial, bedside platelet-function monitoring to adjust antiplatelet therapy after coronary stent implantation did not reduce the rate of subsequent cardiovascular events, a finding that calls into question the clinical value of this type of testing. Clopidogrel and aspirin play a central role in the treatment of patients undergoing percutaneous coronary intervention. 1 Up to one third of patients have inadequate platelet inhibition, with an increased risk of events. 2 – 5 Platelet-function testing can determine the degree of platelet reactivity during treatment at the bedside and potentially identify patients in whom adjustment of antiplatelet therapy is warranted to minimize the risks of both ischemic and bleeding complications. 6 Cohort studies and meta-analyses have largely shown the prognostic value of high platelet reactivity during antiplatelet therapy in patients undergoing coronary stenting. 7 , 8 Randomized clinical trials have also shown that stronger . . .
Bibliografia:ObjectType-Article-1
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ISSN:0028-4793
1533-4406
1533-4406
DOI:10.1056/NEJMoa1209979