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• W2034542399 abstract "The concept of clopidogrel resistance emerged several years ago. Since then, many studies have been performed to elucidate the mechanisms and potential clinical impact of this biological finding. These studies identified complex mechanisms, including drug–drug interactions, genetic polymorphisms and clinical factors, and showed consistently the clinical relevance of the variability of clopidogrel response, with higher ischaemic risk in low-responders or non-responders, and higher bleeding risk in hyper-responders. Several strategies for overcoming clopidogrel resistance have been evaluated in small clinical studies, but the benefit of tailored antiplatelet therapy has yet to be validated in large randomized trials, which are currently ongoing. Upcoming antiplatelet drugs that are more potent will change the field of antiplatelet therapy in acute coronary syndromes. The future of antiplatelet therapy sounds more complex, with different drugs, and tailored therapy based on platelet tests and/or genetic testing, but it will lead us to propose a more individualized therapy, which hopefully will improve patient outcome. Le concept de résistance au clopidogrel est apparu depuis quelques années. Depuis, de nombreuses études ont été menées pour élucider les mécanismes ainsi que les conséquences cliniques de cette entité biologique. Ces études ont démontré un mécanisme complexe, incluant des interactions médicamenteuses, ainsi que des facteurs génétiques et cliniques, et ont montré de façon constante l’impact clinique de cette variabilité de réponse. De nombreuses stratégies ont été proposées pour s’affranchir de cette résistance, mais le bénéfice d’un traitement individualisé sur les tests plaquettaires doit encore être démontré dans de larges essais cliniques, actuellement en cours. Les nouvelles molécules antiplaquettaires, plus puissantes, vont bien sûr modifier le traitement antiplaquettaire des syndromes coronariens aigus. Le traitement antiplaquettaire du futur apparaît alors plus complexe avec différentes molécules, voire un traitement individualisé sur les tests plaquettaires et/ou génétiques, mais cela nous amènera à proposer un traitement plus personnalisé à chaque patient, ce qui ne peut qu’améliorer leur pronostic." @default.
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• W2034542399 date "2010-06-01" @default.
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• W2034542399 title "Clopidogrel resistance: What's new?" @default.
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• W2034542399 doi "https://doi.org/10.1016/j.acvd.2010.05.001" @default.
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