Pp. 79-103 (25)
Dilek Ural, İrem Yılmaz and Kurtuluş Karaüzüm
Antiplatelet therapy is the keystone in secondary prevention of the patients with
cardiovascular diseases. The efficacy of aspirin, clopidogrel and novel oral antiplatelets like
prasugrel and ticagrelor in atherotrombotic events has been shown in several landmark
clinical trials and meta-analyses. Nevertheless, a significant number of patients experience
recurrent events despite antiplatelet therapy. Increasing evidence indicates that there is
considerable variability in response to antiplatelet therapy among patients and those who
have higher levels of platelet reactivity are at increased risk for recurrent ischaemic events.
These findings raised the possibility that decreased response, or ‘resistance’ to oral
antiplatelet drugs may underlie many subsequent major cardiovascular events (MACE).
The main problem with ‘resistance’ is the lack of a clear definition. In this chapter, aspirin,
clopidogrel and glycoprotein IIb/IIIa receptor inhibitor resistance in patients with acute
coronary syndromes will be discussed by the concept of residual platelet activity.
Antiplatelet, antiplatelet resistance, aspirin, clopidogrel, aspirin
resistance, clopidogrel resistance, acute coronary syndrome, platelet function assays.
Kocaeli University, School of Medicine, Department of Cardiology Umuttepe Kampüsü - 41380 Kocaeli/Türkiye.