Antiplatelet drugs in patients with enhanced platelet turnover: biomarkers versus platelet function testing.
Platelets are key players in atherothrombosis. Antiplatelet therapy comprising aspirin alone or with P2Y12-inhibitors are effective for prevention of atherothrombotic complications. However, there is interindividual variability in the response to antiplatelet drugs, leaving some patients at increased risk of recurrent atherothrombotic events. Several risk factors associated with high on-treatment platelet reactivity (HTPR), including elevated platelet turnover, have been identified. Platelet turnover is adequately estimated from the fraction of reticulated platelets. Reticulated platelets are young platelets, characterised by residual messenger RNA. They are larger, haemostatically more active and there is evidence that platelet turnover is a causal and prognostic factor in atherothrombotic disease. Whether platelet turnover per se represents a key factor in pathogenesis, progression and prognosis of atherothrombotic diseases (with focus on acute coronary syndromes) or whether it merely facilitates insufficient platelet inhibition will be discussed in this state-of-the art review.
['Freynhofer|Matthias K|MK|', 'Gruber|Susanne C|SC|', 'Grove|Erik L|EL|', 'Weiss|Thomas W|TW|', 'Wojta|Johann|J|', 'Huber|Kurt|K|']
D050197:Atherosclerosis D015415:Biomarkers D001792:Blood Platelets D006801:Humans D007700:Kinetics D010975:Platelet Aggregation Inhibitors D010979:Platelet Function Tests D011237:Predictive Value of Tests D058921:Purinergic P2Y Receptor Antagonists D058925:Receptors, Purinergic P2Y12 D034061:Thrombopoiesis D013927:Thrombosis D016896:Treatment Outcome
Platelet turnover aspirin reticulated platelets P2Y12 inhibitors mean platelet volume