Abstract
In an ideal world, 100 patients given the same dose
of the same drug would display the same pharmacological
response, implying identical pharmacokinetics
(what the body does to the drug) and pharmacodynamics
(what the drug does to the body). The real world,
however, is one of interindividual pharmacokinetic
and pharmacodynamic variability. How this determines
the response to aspirin and platelet adenosine
diphosphate receptor (P2Y12) blockers is the subject of
this review, designed to help cardiologists critically
assess the overwhelming literature on “resistance” to
these antiplatelet drugs and gauge the utility and
limitations of current biochemical, functional, and
genetic tests of individual drug response. The term
“resistance” is uninformative of the mechanism(s)
behind interindividual variability in response and
potentially misleading, implying we have a standardized
method of measurement directly reflecting clinical
efficacy that can dictate changes in antiplatelet therapy.
In fact, the relationship between the functional
indices of platelet capacity measurable ex vivo and
the occurrence of platelet activation and inhibition in
vivo is far from established. We therefore suggest abandoning
the term “resistance” if we are to advance our
understanding of the complex determinants of interindividual
variability in response to aspirin and P2Y12
blockers discussed here and elsewhere in this issue.
Lingua originale | English |
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pagine (da-a) | 5-20 |
Numero di pagine | 16 |
Rivista | Dialogues in Cardiovascular Medicine |
Volume | 16 |
Stato di pubblicazione | Pubblicato - 2011 |
Keywords
- antiplatelet drugs
- platelet