Clopidogrel Platelet Function Tests
Caveats and Controversies
Light transmission platelet aggregometry (LTA) is the gold standard of platelet function testing. It has been used for several decades for detecting hereditary platelet abnormalities such as Bernard Soulier syndrome, Glanzmann’s thrombasthenia and von Willebrand disease. Because it is time and labor intensive, it is seldom used for monitoring resistance to clopidogrel. Testing is most accurate when the patient stops using all medications prior to collection, particularly any anticoagulants. This is true of all platelet function testing (except the specific drug when testing for resistance) and is not always possible due to the patient’s co-morbidities.
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- Learning Objectives
- Platelet Function Tests for the Detection of Clopidogrel Resistance1
- Platelet Function Tests for the Detection of Clopidogrel Resistance
- Caveat: There Is No Perfect Platelet Function Test...
- Problems With Testing For Clopidogrel
- How We Choose a Testing Method
- Methodology Table
- Platelet Function Testing Available at Mayo Clinic Florida
- Light Transmission Platelet Aggregometry Studies (LTA)
- Platelet Aggregation (Cont'd)
- Normal Patient
- Accumetrics VerifyNow Test
- VerifyNow P2Y12 Test
- P2Y12 Test Interferences
- P2Y12 Antagonists2
- Can These Platelet Function Tests Be Used for Ticagrelor (Brilinta/Brilique)?
- PFA–100 (Cont'd)
- INNOVANCE PFA P2Y
- TEG — Platelet Mapping
- Results of VerifyNow Testing
- 2009–2011 Clopidogrel Response at 30%
- Genetic Testing: Clopidogrel Metabolism
- Clopidogrel Metabolism
- Number of Gene Polymorphisms
- Clopidogrel Metabolism and Genetic Polymorphisms
- Why Do Genetic Testing?
- Clopidogrel Genetics (Cont'd)
- Caveats — Other Reasons for Poor Response to Clopidogrel
- CYP2C19 Polymorphism May Require Another Factor
- Controversy for Clopidogrel
- Warning: Diminished Effectiveness In Poor Metabolizers
- What Does Warning Mean For Clinicians With Patients On Clopidogrel?
- FDA Answer
- More Questions