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

Bath, Philip M. and 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

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Abstract

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.

Item Type: Article
Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis in Platelets on 18 April 2018, available online: http://www.tandfonline.com/10.1080/09537104.2018.1445839
Keywords: Acute coronary syndrome, bleeding, function, platelet, P-selectin, stroke
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Clinical Neuroscience
Identification Number: https://doi.org/10.1080/09537104.2018.1445839
Depositing User: Eprints, Support
Date Deposited: 02 May 2018 14:19
Last Modified: 03 May 2018 05:33
URI: http://eprints.nottingham.ac.uk/id/eprint/51535

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