Old and New Molecular Mechanisms Associated with Platelet Resistance to Antithrombotics |
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Authors: | Antonio J López Farré Juan Tamargo Petra J Mateos-Cáceres Luís Azcona Carlos Macaya |
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Institution: | 1.Cardiovascular Research Unit, Cardiology Department,Hospital Clínico San Carlos,Madrid,Spain;2.Pharmacology Department. School of Medicine,Universidad Complutense,Madrid,Spain |
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Abstract: | Current available data show that about 5 to 40% of coronary patients treated with conventional doses of antithrombotic drugs
do not display adequate antiplatelet response. Nowadays, aspirin remains the main antiplatelet therapy. However, a significant
number of patients show platelet resistance to aspirin therapy, and recurrent thrombotic events occur. Combined antithrombotic
therapies with thienopyridines, such as clopidogrel have been used to resolve this problem. However, clopidogrel treatment
has been also associated with wide response variability, and non-responsiveness to clopidogrel also occurs in some patients.
Therefore, the main question arising about the antithrombotic therapy is why particular patients do not benefit from the therapy
and how they might be identified to improve their treatment. Different hypotheses have been suggested, including genetic factors,
platelet heterogeneity, non-compliance and others. However, it is probably that many molecular mechanisms involved in platelet
resistance to antithrombotic therapies still remains unknown. New technologies, such as proteomics and genetic, are beginning
to show new unknown biological biomarkers and molecular mechanisms which may be associated with platelet antithrombotic drug
resistance. |
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