Platelet function testing in transient ischaemic attack and ischaemic stroke: A comprehensive systematic review of the literature

摘要: The majority of patients with ischaemic cerebrovascular disease (CVD) are not protected from further vascular events antiplatelet therapy. Measurement inhibition platelet function ex vivo on therapy, using laboratory tests that correlate the clinical effectiveness these agents, would potentially enable physicians to tailor therapy suit individuals. A systematic review literature was performed collate all available data function/reactivity in CVD patients, especially those treated aspirin, dipyridamole or clopidogrel. Particular emphasis paid information commonly whole blood analysers (PFA-100®, VerifyNow® and Multiplate®). Data pharmacogenetic mechanisms influencing high on-treatment reactivity (HTPR) were reviewed. Two-hundred forty-nine relevant articles identified; 93 manuscripts met criteria for inclusion. prevalence HTPR varies between 3-62% aspirin monotherapy, 8-61% clopidogrel monotherapy 56-59% when is added early, subacute late phases after TIA/stroke onset. higher PFA-100 than VerifyNow one study (p < 0.001). Furthermore, lower used 'novel longitudinal' rather 'cross-sectional, case-control' definitions PFA early TIA stroke = 0.003; 1 study). Studies assessing influence genetic polymorphisms limited, need validation large multicentre studies. Available illustrate an important proportion have their prescribed regimen, depending definition assay used. Large, adequately-sized, prospective collaborative studies urgently needed determine whether comprehensive assessment at low shear stress a range user-friendly testing platforms, conjunction data, improves our ability predict risk recurrent thus enhance secondary prevention following stroke.