Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=29967831
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
Anti-platelet Therapy Resistance - Concept, Mechanisms and Platelet Function
Tests in Intensive Care Facilities
#MMPMID29967831
M?rginean A
; B?nescu C
; Scridon A
; Dobreanu M
J Crit Care Med (Targu Mures)
2016[Jan]; 2
(1
): 6-15
PMID29967831
show ga
It is well known that critically ill patients require special attention and
additional consideration during their treatment and management. The multiple
systems and organ dysfunctions, typical of the critical patient, often results in
different patterns of enteral absorption in these patients. Anti-platelet drugs
are the cornerstone in treating patients with coronary and cerebrovascular
disease. Dual anti-platelet therapy with aspirin and clopidogrel is the treatment
of choice in patients undergoing elective percutaneous coronary interventions and
is still widely used in patients with acute coronary syndromes. However, despite
the use of dual anti-platelet therapy, some patients continue to experience
cardiovascular ischemic events. Recurrence of ischemic events is partly
attributed to the fact that some patients have poor inhibition of platelet
reactivity despite treatment. These patients are considered low- or
non-responders to therapy. The underlying mechanisms leading to resistance are
not yet fully elucidated and are probably multifactorial, cellular, genetic and
clinical factors being implicated. Several methods have been developed to asses
platelet function and can be used to identify patients with persistent platelet
reactivity, which have an increased risk of thrombosis. In this paper, the
concept of anti-platelet therapy resistance, the underlying mechanisms and the
methods used to identify patients with low responsiveness to anti-platelet
therapy will be highlighted with a focus on aspirin and clopidogrel therapy and
addressing especially critically ill patients.
free
free
free
