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Medicina & Laboratorio

2017, Number 03-04

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Medicina & Laboratorio 2017; 23 (03-04)

Platelet P2Y12 receptor inhibitors. Part 2 of 2: Etiology, diagnosis and management of resistance

Campuzano-Maya G

Language: Spanish
References: 290
Page: 113-148
PDF size: 807.85 Kb.


ABSTRACT

Cardiovascular diseases, including in general affections of heart, brain, and blood vessels, are the leading worldwide cause of death with seventeen millions of deaths annually and a third part of them are due to thrombotic events. Platelet antiaggregation with different agents, like inhibitors of the platelet receptor P2Y12, has become the cornerstone of primary and secondary prevention and for the treatment of cardiovascular diseases, as acute myocardial infarction, stroke, and thrombotic diseases. However, several research studies have shown a decrease in the in vivo response to these substances in some individuals, which is expressed as resistance. The first module addressed the role of platelets in atherothrombotic disease and described the six P2Y12 platelet receptor inhibitors available for current or future clinical use: ticlopidine, clopidogrel, prasugrel, ticagrelor, cangrelor and elinogrel. In this second module, it will discuss the concept of resistance to P2Y12 platelet receptor inhibitors, particularly clopidogrel, the resistance etiology, and antiplatelet monitoring with inhibitors of P2Y12 platelet receptor by platelet function tests, as a way to make a «personalized antiaggregation». Finally, it will give the basic guidelines for the management of resistance to P2Y12 platelet receptor inhibitors.


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