This editorial discusses the clinical challenge of recurrent vascular events despite platelet inhibitor therapy, often termed 'resistance', in the context of acute coronary syndromes.
Despite great progress in the diagnosis and treatment of unstable coronary syndromes, it is estimated that 785,000 Americans will have new acute cardiac events and 470,000 will have recurrent events this year.1 Central to the pathogenesis of acute coronary syndromes is the adhesion and activation of platelets leading to aggregation, thrombus formation, and vessel occlusion. Unfortunately, the absolute risk of recurrent vascular events among patients taking platelet inhibitors remains relatively high.1 The observation that platelet-dependent thrombosis occurs despite treatment with platelet inhibitors has led to a large number of studies assessing the cause of these treatment failures. Often termed “resistance,” . . .
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Freedman et al. (2009) studied this question.