Laboratory monitoring of antiplatelet therapy using platelet aggregation tests is not recommended, as randomized clinical trials failed to show any advantage of this strategy.
Does laboratory monitoring of antiplatelet therapy improve efficacy and safety in patients with thrombotic arterial occlusions?
Routine laboratory monitoring of antiplatelet therapy with platelet aggregation tests is not recommended as it does not improve clinical outcomes.
A variety of laboratory tests have been developed, which can diagnose a number of both congenital and acquired disorders of platelet function. Many tests of platelet function measure the ability of platelets to adhere to each other, forming platelet aggregates, which represent the major constituents of hemostatic plugs and of arterial thrombi. Light transmission aggregometry (LTA) is still considered the gold standard of platelet aggregation tests, but other platelet aggregation-based tests are also available. Among them, the flow cytometry-based methods may be more convenient than LTA for the study of patients with very low or very high platelet counts. The use of platelet aggregation tests has also been advocated to monitor the treatment with antiplatelet agents (mostly the P2Y12 antagonist clopidogrel) of patients with thrombotic arterial occlusions, with the aim of improving their efficacy and safety. However, randomized clinical trials failed to show any advantage of this strategy; as a consequence, international guidelines now recommend against laboratory monitoring of antiplatelet therapy.
Podda et al. (Wed,) conducted a review in Disorders of platelet function and antiplatelet therapy monitoring. Platelet aggregation tests (Aggregometry) was evaluated. Laboratory monitoring of antiplatelet therapy using platelet aggregation tests is not recommended, as randomized clinical trials failed to show any advantage of this strategy.