{"id":11949,"date":"2011-09-21T14:18:51","date_gmt":"2011-09-21T18:18:51","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=11949"},"modified":"2011-09-21T14:18:51","modified_gmt":"2011-09-21T18:18:51","slug":"more-data-but-no-answers-about-platelet-function-testing","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2011\/09\/21\/more-data-but-no-answers-about-platelet-function-testing\/","title":{"rendered":"More Data but No Answers About Platelet Function Testing"},"content":{"rendered":"<p>The RECLOSE 2\u2013ACS (Responsiveness to Clopidogrel\u00a0and Stent Thrombosis 2\u2013ACS) trial from Italy\u00a0provides new information about platelet reactivity but doesn&#8217;t answer any of the key questions about the possible role of platelet function testing in clinical practice.<\/p>\n<p>In <a href=\"http:\/\/jama.ama-assn.org\/content\/306\/11\/1215.abstract\">a paper published in <em>JAMA<\/em><\/a>, Guido Parodi and colleagues report on 1,789 ACS patients who underwent PCI and who had their platelet reactivity measured. Patients found to have high residual platelet reactivity (HRPR) received a larger dose of clopidogrel or were switched to ticlopidine.<\/p>\n<ul>\n<li>After 2 years&#8217; follow-up, the rate of cardiac death, MI, urgent coronary revascularization, or stroke was 14.6% in the group\u00a0with HRPR versus 8.7% in the group with low residual platelet reactivity (absolute risk increase: 5.9%; CI 1.6%-11.1%, p=0.003).<\/li>\n<li>Within the HRPR group, there was no difference in outcome between patients who, after treatment, had an ADP test result below 70% and those with an ADP result of 70% or above.<\/li>\n<li>Stent thrombosis occurred in 6.1% of patients with HRPR versus 2.9% of those with low residual platelet reactivity (absolute risk increase: 3.2%, CI 0.4%-6.7%; p=0.01).<\/li>\n<\/ul>\n<p>In <a href=\"http:\/\/jama.ama-assn.org\/content\/306\/11\/1260.full\">an accompanying editorial<\/a>, Dominick Angiolillo writes that the absence of benefit on the primary endpoint with adjusted therapies &#8220;leaves unsolved the pivotal dilemma of whether platelet reactivity is simply a marker of risk or if it is a modifiable risk factor that can affect prognosis.&#8221; Platelet function testing, says Angiolillo, remains a research tool: &#8220;Currently available evidence cannot support routine use of\u00a0PFT in clinical practice.&#8221;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The RECLOSE 2\u2013ACS (Responsiveness to Clopidogrel\u00a0and Stent Thrombosis 2\u2013ACS) trial from Italy\u00a0provides new information about platelet reactivity but doesn&#8217;t answer any of the key questions about the possible role of platelet function testing in clinical practice. In a paper published in JAMA, Guido Parodi and colleagues report on 1,789 ACS patients who underwent PCI and [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[334,760,335,240],"class_list":["post-11949","post","type-post","status-publish","format-standard","hentry","category-interventional-cardiology","tag-clopidogrel","tag-platelet-function-tests","tag-prasugrel","tag-ticagrelor"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/11949","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=11949"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/11949\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=11949"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=11949"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=11949"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}