Insufficient effectiveness of antithrombotic therapy - clinical associations and current opinions on its laboratory assessment
Abstract
Laboratory demonstration of insufficient platelet inhibition correlates with the clinical incidence of thrombotic complications. What is missing, however, is the evidence of how to proceed in patients with a laboratory demonstration of insufficient effectiveness of antiplatelet therapy, i.e.those with increased residual platelet aggregation.
According to existing data, it is low (1-8%) when acetylsalicylic acid alone is administered when assessing the specific inhibition of arachidonic acid cycle, but more common when assessing the non-specifically induced platelet aggregation due to a non-COX-1 effect of acetylsalicylic acid (5-30%). Far more common is the laboratory ineffectiveness of clopidogresl with established progrostically unfavourable consequences due to CYP450 polymorphisms or in interaction with other drugs affecting this receptor or clopidogrel absorption.
Up to 30% of patients treated may be affected ..