Routinebepaling van de mate van bloedplaatjesremming bij gebruik van acetylsalicylzuur of clopidogrel niet zinvol

Stand van zaken
Miranda C.A. Kramer, Rienk Nieuwland, A. (Guus) Sturk en Rob J. de Winter

Routine determination of the extent of platelet inhibition during the use of acetylsalicylic acid or clopidogrel is not worthwhile

There is great interindividual variability in platelet activity in patients on acetylsalicylic acid or clopidogrel.Residual platelet activity during acetylsalicylic acid and/or clopidogrel treatment should be more properly termed 'treatment failure' instead of 'clinical resistance'.At present, routine monitoring of so-called 'resistance' to acetylsalicylic acid or clopidogrel in individual patients is not recommended in clinical practice.Available platelet function tests have not been standardized and do not correlate well with each other. The laboratory diagnosis of 'resistance' therefore depends on the test being used.Large clinical studies are needed to establish whether patients with high residual platelet activity despite antiplatelet therapy are at risk of thrombotic events.Considering the high morbidity and mortality of cardiovascular disease, studies are required to evaluate determinants of antiplatelet treatment failure, to establish the predictive value of various platelet function tests, and to determine the effectiveness of treatments for resistance.