Clopidogrel resistance is associated with great adverse outcomes, early recognition of these patients is very important. However the major problem in this issue is the lack of standardized method and cut-off values in definition of clopidogrel resistance. A few methods have been used but none have been fully standardized or fully agreed upon to measure clopidogrel responsiveness [52]. As discussed above platelet function tests are expensive ,time consuming and complicated , however this relatively simple and readily available test; measurement of MPV by automated cell counter, has been accepted as a surrogate marker of platelet function [10]. In the few existing literature about correlation of MPV levels and clopidogrel resistance, Asher et
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Further suggesting that dual antiplatelet therapy half-life in the plasma is short, and the daily doses might not be able to adequately inhibit newly formed platelets in a high turnover state; and possibly that new platelets could regenerate more COX-1 and P2Y12 receptors for activation [61]. However their study did not conclude that large platelets modify responses to antiplatelet therapy but provided evidence that large platelets are more active and could potentially have an independent role in modifying the effects of antiplatelet therapy [58]. Established cardiovascular risk factors, such as smoking, hypertension [29,62,63], dyslipidemia, and diabetes, can influence MPV, and have demonstrated to have an individual variability of platelet response to clopidogrel [25-25] [64]. Increased platelet reactivity is a component of the diabetic prothrombotic state. Aldona et al [57] demonstrated in their study that diabetes and glycemic control measured by glycosylated hemoglobin, but not glucose blood concentration, were found to be predictors of low, both acute and chronic, response to …show more content…
Thus MPV can be used as a predictor of clopidogrel resistance in ACS patients.
We would like to highlight the fact that the easily available Mean platelet volume (MPV) an indicator of platelet size and activity can be used as markers of high on-treatment platelet reactivity and predictor of clopidogrel resistance. Unfortunately no pre-analytical standards have been
Further suggesting that dual antiplatelet therapy half-life in the plasma is short, and the daily doses might not be able to adequately inhibit newly formed platelets in a high turnover state; and possibly that new platelets could regenerate more COX-1 and P2Y12 receptors for activation [61]. However their study did not conclude that large platelets modify responses to antiplatelet therapy but provided evidence that large platelets are more active and could potentially have an independent role in modifying the effects of antiplatelet therapy [58]. Established cardiovascular risk factors, such as smoking, hypertension [29,62,63], dyslipidemia, and diabetes, can influence MPV, and have demonstrated to have an individual variability of platelet response to clopidogrel [25-25] [64]. Increased platelet reactivity is a component of the diabetic prothrombotic state. Aldona et al [57] demonstrated in their study that diabetes and glycemic control measured by glycosylated hemoglobin, but not glucose blood concentration, were found to be predictors of low, both acute and chronic, response to …show more content…
Thus MPV can be used as a predictor of clopidogrel resistance in ACS patients.
We would like to highlight the fact that the easily available Mean platelet volume (MPV) an indicator of platelet size and activity can be used as markers of high on-treatment platelet reactivity and predictor of clopidogrel resistance. Unfortunately no pre-analytical standards have been