Impact and Diagnosis of Antiplatelet Therapy Resistance in Patients Undergoing Cardiac Surgery

Abstract

Abstract Clinical Development Phases I‐III Regulatory, Quality, Manufacturing Coronary artery bypass grafting (CABG) is highly effective in the treatment of severe coronary artery disease. Antiplatelet therapy is a critical component of the medical management of patients following CABG. Patient idiosyncrasies in responsiveness to antiplatelet agents, however, lead to variable suppression of platelet aggregation. This problem is underscored by inconsistent findings from the different laboratory instruments used to document antiplatelet drug responsiveness and its uncertain clinical impact. The laboratory results reveal a spectrum of platelet inhibition effects. The cutoff values discriminating between “resistance” and “response” to antiplatelet therapy often rely solely on definition. It is therefore not surprising that regular testing for antiplatelet therapy response has neither been routinely instituted in a wider clinical arena nor is there unequivocal evidence to support it. The purpose of this review is to offer insight into the incidence and clinical impact of antiplatelet therapy resistance in patients undergoing surgical myocardial revascularization.