Importance of measurement of platelet reactivity to ADP in patients with coronary artery disease: an historical account.

Journal Article (Journal Article;Review)

The pivotal roles of platelets in physiological hemostasis and pathological thrombosis at the site of plaque rupture are well established. The latter roles provide the fundamental basis for the most widely implemented pharmacologic management of coronary artery disease--dual antiplatelet therapy with aspirin to inhibit platelet thromboxane A2 generation, and a P2Y12 receptor inhibitor to prevent adenosine diphosphate (ADP)-induced platelet activation. Although suboptimal pharmacodynamic efficacy, also described as high on-treatment platelet reactivity to ADP, has been associated with greater risk for post-stenting ischemic event occurrence, enhanced responsiveness is associated with higher risk for bleeding in selected patients. In this review article, we aim to provide an historical account of the one and a half century long journey starting with the first description of platelets through the first report of ex vivo measurement of ADP-induced platelet aggregation, the first demonstration of an association between ADP-induced platelet aggregation and post-stenting ischemic event occurrence, and finally to the most recent description of a 'therapeutic window' concept for P2Y12 receptor inhibitor therapy.

Full Text

Duke Authors

Cited Authors

  • Tantry, US; Mahla, E; Gesheff, MG; Gurbel, PA

Published Date

  • November 2013

Published In

Volume / Issue

  • 11 / 11

Start / End Page

  • 1547 - 1556

PubMed ID

  • 24147519

Electronic International Standard Serial Number (EISSN)

  • 1744-8344

Digital Object Identifier (DOI)

  • 10.1586/14779072.2013.839382


  • eng

Conference Location

  • England