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Journal ArticleDOI

Recommendations for the standardization of light transmission aggregometry : a consensus of the working party from the platelet physiology subcommittee of SSC/ISTH

TL;DR: The Platelet Physiology Subcommittee of the Scientific and Standardization Committee (SSC) of the International Society on Thrombosis and Haemostasis formed a working party of experts with the aim of producing a series of consensus recommendations for standardizing LTA, which formed the basis of a consensus document, which is the subject of the present report.
About: This article is published in Journal of Thrombosis and Haemostasis.The article was published on 2013-06-01 and is currently open access. It has received 388 citations till now.
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Journal ArticleDOI
TL;DR: Well-tried and innovative platelet function tests and their methodological features and clinical applications are considered and different platelet methodologies for the evaluation of inherited and acquired bleeding disorders and for monitoring antiplatelet therapies are spreading.
Abstract: In physiological hemostasis a prompt recruitment of platelets on the vessel damage prevents the bleeding by the rapid formation of a platelet plug. Qualitative and/or quantitative platelet defects promote bleeding, whereas the high residual reactivity of platelets in patients on antiplatelet therapies moves forward thromboembolic complications. The biochemical mechanisms of the different phases of platelet activation - adhesion, shape change, release reaction, and aggregation - have been well delineated, whereas their complete translation into laboratory assays has not been so fulfilled. Laboratory tests of platelet function, such as bleeding time, light transmission platelet aggregation, lumiaggregometry, impedance aggregometry on whole blood, and platelet activation investigated by flow cytometry, are traditionally utilized for diagnosing hemostatic disorders and managing patients with platelet and hemostatic defects, but their use is still limited to specialized laboratories. To date, a point-of-care testing (POCT) dedicated to platelet function, using pertinent devices much simpler to use, has now become available (ie, PFA-100, VerifyNow System, Multiplate Electrode Aggregometry [MEA]). POCT includes new methodologies which may be used in critical clinical settings and also in general laboratories because they are rapid and easy to use, employing whole blood without the necessity of sample processing. Actually, these different platelet methodologies for the evaluation of inherited and acquired bleeding disorders and/or for monitoring antiplatelet therapies are spreading and the study of platelet function is strengthening. In this review, well-tried and innovative platelet function tests and their methodological features and clinical applications are considered.

357 citations

Journal ArticleDOI
TL;DR: The consensus guidelines developed by a working party within the Platelet Physiology SSC are presented, using expert opinion, a literature review and feedback from public presentations.

201 citations

Journal ArticleDOI
TL;DR: Ticagrelor, a P2Y12 antagonist, is an antiplatelet agent approved for the treatment of acute coronary syndromes; it also inhibits adenosine uptake by erythrocytes and other cells.

136 citations

Journal ArticleDOI
TL;DR: A large number of patients with inherited platelet function disorders are diagnosed with atypical central giant cell granuloma, which is a leading cause of death in women and a major source of complications in men.

129 citations

Journal ArticleDOI
TL;DR: This guidance is intended to assist applicants in preparing applications for the authorisation of health claims related to the antioxidants, oxidative damage and cardiovascular health.
Abstract: EFSA asked the Panel on Dietetic Products, Nutrition and Allergies (NDA) to update the guidance on the scientific requirements for health claims related to antioxidants, oxidative damage and cardiovascular health published in 2011. The update takes into accounts experiences gained with evaluation of additional health claim applications related to antioxidants, oxidative damage and cardiovascular health, and the information collected from a Grant launched in 2014. This guidance is intended to assist applicants in preparing applications for the authorisation of health claims related to the antioxidants, oxidative damage and cardiovascular health. The document was subject to public consultation (from 12 July to 3 September 2017). This document supersedes the guidance on the scientific requirements for health claims related to antioxidants, oxidative damage and cardiovascular health published in 2011. It is intended that the guidance will be further updated as appropriate in the light of experience gained from the evaluation of health claims.

115 citations


Cites background from "Recommendations for the standardiza..."

  • ...28 Cattaneo et al., 2013. www.efsa.europa.eu/efsajournal 14 EFSA Journal 2018;16(1):5136 Studies in patients with varicose veins and associated chronic venous diseases and which relate to the treatment of symptoms of the disease cannot be considered for the scientific substantiation of claims on…...

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References
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Journal ArticleDOI
16 Mar 2011-JAMA
TL;DR: In this paper, the authors evaluated the effect of high-dose compared with standard-dose clopidogrel in patients with high on-treatment platelet reactivity after percutaneous coronary intervention (PCI), but a treatment strategy for this issue was not well defined.
Abstract: Context High platelet reactivity while receiving clopidogrel has been linked to cardiovascular events after percutaneous coronary intervention (PCI), but a treatment strategy for this issue is not well defined. Objective To evaluate the effect of high-dose compared with standard-dose clopidogrel in patients with high on-treatment platelet reactivity after PCI. Design, Setting, and Patients Randomized, double-blind, active-control trial (Gauging Responsiveness with A VerifyNow assay—Impact on Thrombosis And Safety [GRAVITAS]) of 2214 patients with high on-treatment reactivity 12 to 24 hours after PCI with drug-eluting stents at 83 centers in North America between July 2008 and April 2010. Interventions High-dose clopidogrel (600-mg initial dose, 150 mg daily thereafter) or standard-dose clopidogrel (no additional loading dose, 75 mg daily) for 6 months. Main Outcome Measures The primary end point was the 6-month incidence of death from cardiovascular causes, nonfatal myocardial infarction, or stent thrombosis. The key safety end point was severe or moderate bleeding according to the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) definition. A key pharmacodynamic end point was the rate of persistently high on-treatment reactivity at 30 days. Results At 6 months, the primary end point had occurred in 25 of 1109 patients (2.3%) receiving high-dose clopidogrel compared with 25 of 1105 patients (2.3%) receiving standard-dose clopidogrel (hazard ratio [HR], 1.01; 95% confidence interval [CI], 0.58-1.76; P = .97). Severe or moderate bleeding was not increased with the high-dose regimen (15 [1.4%] vs 25 [2.3%], HR, 0.59; 95% CI, 0.31-1.11; P = .10). Compared with standard-dose clopidogrel, high-dose clopidogrel provided a 22% (95% CI, 18%-26%) absolute reduction in the rate of high on-treatment reactivity at 30 days (62%; 95% CI, 59%-65% vs 40%; 95% CI, 37%-43%; P Conclusions Among patients with high on-treatment reactivity after PCI with drug-eluting stents, the use of high-dose clopidogrel compared with standard-dose clopidogrel did not reduce the incidence of death from cardiovascular causes, nonfatal myocardial infarction, or stent thrombosis. Trial Registration clinicaltrials.gov Identifier: NCT00645918

1,174 citations

01 Jan 2011
TL;DR: Among patients with high on-treatment reactivity after PCI with drug-eluting stents, the use of high-dose clopidogrel compared with standard- dose clopIDogrel did not reduce the incidence of death from cardiovascular causes, nonfatal myocardial infarction, or stent thrombosis.
Abstract: Matthew J. Price, MDPeter B. Berger, MDPaul S. Teirstein, MDJean-Franc¸ois Tanguay, MDDominick J. Angiolillo, MDDouglas Spriggs, MDSanjeev Puri, MDMark Robbins, MDKirk N. Garratt, MDOlivier F. Bertrand, MDMichael E. Stillablower, MDJoseph R. Aragon, MDDavid E. Kandzari, MDCurtiss T. Stinis, MDMichael S. Lee, MDSteven V. Manoukian, MDChristopher P. Cannon, MDNicholas J. Schork, PhDEric J. Topol, MDfor the GRAVITAS Investigators

856 citations

Journal ArticleDOI
TL;DR: This study showed no significant improvements in clinical outcomes with platelet-function monitoring and treatment adjustment for coronary stenting, as compared with standard antiplatelet therapy without monitoring.
Abstract: In the monitoring group, high platelet reactivity in patients taking clopidogrel (34.5% of patients) or aspirin (7.6%) led to the administration of an additional bolus of clopidogrel, prasugrel, or aspirin along with glycoprotein IIb/IIIa inhibitors during the procedure. The primary end point occurred in 34.6% of the patients in the moni - toring group, as compared with 31.1% of those in the conventional-treatment group (hazard ratio, 1.13; 95% confidence interval (CI), 0.98 to 1.29; P = 0.10). The main secondary end point, stent thrombosis or any urgent revascularization, occurred in 4.9% of the patients in the monitoring group and 4.6% of those in the conventional- treatment group (hazard ratio, 1.06; 95% CI, 0.74 to 1.52; P = 0.77). The rate of major bleeding events did not differ significantly between groups. CONCLUSIONS This study showed no significant improvements in clinical outcomes with platelet- function monitoring and treatment adjustment for coronary stenting, as compared with standard antiplatelet therapy without monitoring. (Funded by Allies in Cardiovas -

812 citations

Journal ArticleDOI
TL;DR: The new technique is very suitable for investigating platelet pharmacology, since the inhibitors of aggregation, such as indomethacin and prostacyclin, can be conveniently quantitated in blood by using this technique.

697 citations