Stable Angina Pectoris Clinical Trial
Official title:
Do Point-of-care Platelet Function Assays Predict Clinical Outcomes in Clopidogrel Pre-treated Patients Undergoing Elective PCI. (The POPular Study)
The purpose of this study is to investigate whether the level of Platelet Inhibition as assessed with five point-of-care platelet function assays correlates with clinical (periprocedural) outcomes such as Acute Myocardial Infarction, death, Target Vessel revascularization and/or stroke in patients undergoing elective PCI.
Antiplatelet agents—aspirin, thienopyridines, and platelet glycoprotein IIb/IIIa (GpIIb/IIIa)
inhibitors—have become cornerstones in the treatment of ischemic heart disease for patients
undergoing percutaneous coronary intervention (PCI)1,2. However, several studies have
demonstrated with the use of platelet function assays that subgroups of patients receiving
either aspirin, clopidogrel, or both fail to produce the anticipated antiplatelet effect3-5.
Consequently, terms like "aspirin-resistance" and "clopidogrel resistance" have been
introduced in literature.
Light transmittance platelet aggregometry is generally considered to be the gold standard for
determining platelet function, but its relevance to in vivo platelet function is questionable
and the logistically demands of the method make it impossible to use in daily practice. In
addition, aggregation is just one of several important platelet functions. The introduction
of several point-of-care assays may be the key to the widespread clinical use of platelet
function testing to identify so called anti-platelet therapy low-responders. However, whether
these point-of-care platelet function tests provide predictive value (i.e. correlate with
clinical outcomes) and the allocation of the "best" or most suitable point-of-care Platelet
function assay to determine the level of inhibition of platelet function remains to be
established.
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