Clinical utility of remote platelet function measurement using P-selectin: assessment of aspirin, clopidogrel, and prasugrel and bleeding disorders

Vascular diseases such as myocardial infarction and ischemic stroke are associated with increased platelet function whilst the risk of recurrence is reduced by antiplatelet agents such as aspirin, clopidogrel, and prasugrel. However, some patients exhibit high platelet reactivity, especially with cl...

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Main Authors: Bath, Philip M., May, Jane, Heptinstall, Stan
Format: Article
Language:English
Published: Taylor & Francis 2018
Subjects:
Online Access:https://eprints.nottingham.ac.uk/51535/
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author Bath, Philip M.
May, Jane
Heptinstall, Stan
author_facet Bath, Philip M.
May, Jane
Heptinstall, Stan
author_sort Bath, Philip M.
building Nottingham Research Data Repository
collection Online Access
description Vascular diseases such as myocardial infarction and ischemic stroke are associated with increased platelet function whilst the risk of recurrence is reduced by antiplatelet agents such as aspirin, clopidogrel, and prasugrel. However, some patients exhibit high platelet reactivity, especially with clopidogrel. Existing platelet function tests may not be ideal in that they can be expensive, are often time consuming, and measurements must be made near to the patient and within a few hours of blood collection. Platelet activation leads to translocation of P-selectin from alpha-granules to the cell surface. Following activation with arachidonic acid (which is blocked by aspirin) or adenosine diphosphate (inhibited by clopidogrel) and fixation, samples may be stored or posted to a laboratory performing flow cytometric quantification of platelet P-selectin expression. Acute myocardial infarction and ischemic stroke are associated with high platelet reactivity on clopidogrel in 6–58% of patients when assessed with P-selectin expression, and high reactivity was associated with an increased risk of recurrence after myocardial infarction. Use of P-selectin expression tests may also be of relevance to surgical and veterinary practice and the diagnosis of mild bleeding disorders. The present review explores this topic in further detail.
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spelling nottingham-515352018-05-03T05:33:02Z https://eprints.nottingham.ac.uk/51535/ Clinical utility of remote platelet function measurement using P-selectin: assessment of aspirin, clopidogrel, and prasugrel and bleeding disorders Bath, Philip M. May, Jane Heptinstall, Stan Vascular diseases such as myocardial infarction and ischemic stroke are associated with increased platelet function whilst the risk of recurrence is reduced by antiplatelet agents such as aspirin, clopidogrel, and prasugrel. However, some patients exhibit high platelet reactivity, especially with clopidogrel. Existing platelet function tests may not be ideal in that they can be expensive, are often time consuming, and measurements must be made near to the patient and within a few hours of blood collection. Platelet activation leads to translocation of P-selectin from alpha-granules to the cell surface. Following activation with arachidonic acid (which is blocked by aspirin) or adenosine diphosphate (inhibited by clopidogrel) and fixation, samples may be stored or posted to a laboratory performing flow cytometric quantification of platelet P-selectin expression. Acute myocardial infarction and ischemic stroke are associated with high platelet reactivity on clopidogrel in 6–58% of patients when assessed with P-selectin expression, and high reactivity was associated with an increased risk of recurrence after myocardial infarction. Use of P-selectin expression tests may also be of relevance to surgical and veterinary practice and the diagnosis of mild bleeding disorders. The present review explores this topic in further detail. Taylor & Francis 2018-04-18 Article PeerReviewed application/pdf en cc_by https://eprints.nottingham.ac.uk/51535/2/Clinical%20utility%20of%20remote%20platelet%20function%20measurement%20using%20P%20selectin%20assessment%20of%20aspirin%20clopidogrel%20and%20prasugrel%20and%20bleeding%20disorders.pdf Bath, Philip M., May, Jane and Heptinstall, Stan (2018) Clinical utility of remote platelet function measurement using P-selectin: assessment of aspirin, clopidogrel, and prasugrel and bleeding disorders. Platelets . ISSN 1369-1635 Acute coronary syndrome bleeding function platelet P-selectin stroke https://www.tandfonline.com/doi/full/10.1080/09537104.2018.1445839 doi:10.1080/09537104.2018.1445839 doi:10.1080/09537104.2018.1445839
spellingShingle Acute coronary syndrome
bleeding
function
platelet
P-selectin
stroke
Bath, Philip M.
May, Jane
Heptinstall, Stan
Clinical utility of remote platelet function measurement using P-selectin: assessment of aspirin, clopidogrel, and prasugrel and bleeding disorders
title Clinical utility of remote platelet function measurement using P-selectin: assessment of aspirin, clopidogrel, and prasugrel and bleeding disorders
title_full Clinical utility of remote platelet function measurement using P-selectin: assessment of aspirin, clopidogrel, and prasugrel and bleeding disorders
title_fullStr Clinical utility of remote platelet function measurement using P-selectin: assessment of aspirin, clopidogrel, and prasugrel and bleeding disorders
title_full_unstemmed Clinical utility of remote platelet function measurement using P-selectin: assessment of aspirin, clopidogrel, and prasugrel and bleeding disorders
title_short Clinical utility of remote platelet function measurement using P-selectin: assessment of aspirin, clopidogrel, and prasugrel and bleeding disorders
title_sort clinical utility of remote platelet function measurement using p-selectin: assessment of aspirin, clopidogrel, and prasugrel and bleeding disorders
topic Acute coronary syndrome
bleeding
function
platelet
P-selectin
stroke
url https://eprints.nottingham.ac.uk/51535/
https://eprints.nottingham.ac.uk/51535/
https://eprints.nottingham.ac.uk/51535/