Cardiology 2013

Journal: J Am Coll Cardiol

Volume: 62

Issue: 7

Pages: 649-65

Date: Aug 13

Short Title: ACCF/ACR/AIUM/ASE/IAC/SCAI/SCVS/SIR/SVM/SVS/SVU 2013 appropriate use criteria for peripheral vascular ultrasound and physiological testing part II: testing for venous disease and evaluation of hemodialysis access: a report of the american college of cardiology foundation appropriate use criteria task force

Alternate Journal: Journal of the American College of Cardiology

ISSN: 1558-3597 (Electronic)

0735-1097 (Linking)

DOI: 10.1016/j.jacc.2013.05.001

Accession Number: 23876422

Keywords: Advisory Committees/standards

American Heart Association

Cardiology/standards

Female

Guideline Adherence

Humans

Male

Peripheral Vascular Diseases/*ultrasonography

Practice Guidelines as Topic/*standards

Renal Dialysis/methods/standards

Societies, Medical/standards

Ultrasonography, Interventional/standards

United States

Vascular Access Devices/*standards

Venous Thrombosis/*ultrasonography

Notes: Gornik, Heather L

Gerhard-Herman, Marie D

Misra, Sanjay

Mohler, Emile R 3rd

Zierler, R Eugene

eng

R01 HL098967/HL/NHLBI NIH HHS/

Comparative Study

Review

2013/07/24 06:00

J Am Coll Cardiol. 2013 Aug 13;62(7):649-65. doi: 10.1016/j.jacc.2013.05.001. Epub 2013 Jul 19.

URL: http://www.ncbi.nlm.nih.gov/pubmed/23876422

 

 

Reference Type:  Journal Article

Record Number: 703Author: Gorog, D. A. and Fuster, V.

Year: 2013

Title: Platelet function tests in clinical cardiology: unfulfilled expectations

Journal: J Am Coll Cardiol

Volume: 61

Issue: 21

Pages: 2115-29

Date: May 28

Short Title: Platelet function tests in clinical cardiology: unfulfilled expectations

Alternate Journal: Journal of the American College of Cardiology

ISSN: 1558-3597 (Electronic)

0735-1097 (Linking)

DOI: 10.1016/j.jacc.2012.11.080

Accession Number: 23541972

Keywords: Blood Platelets/*physiology

Cardiology/*methods

Humans

*Platelet Activation

Platelet Function Tests/methods

Thrombosis/*blood

Abstract: This review is a critical evaluation of publications in the past decade on the usefulness of platelet function tests (PFTs) in clinical cardiology, in aiding diagnosis, predicting risk, and monitoring therapy. The ideal PFT should: 1) detect baseline platelet hyperreactivity; 2) allow individualization of antiplatelet medication; 3) predict thrombotic risk; and 4) predict bleeding risk. The practicalities of clinical cardiology demand rapid, accurate, and reliable tests that are simple to operate at the bedside and available 24 h a day, 7 days a week. Point-of-care PFTs most widely evaluated clinically include PFA-100 and VerifyNow. None of these tests can reliably detect platelet hyperreactivity and thus identify a prothrombotic state. Identification of antiplatelet nonresponsiveness or hyporesponsiveness is highly test specific, and does not allow individualization of therapy. The power of PFTs in predicting thrombotic events for a given individual is variable and often modest, and alteration of antithrombotic treatment on the basis of the results of PFTs has not been shown to alter clinical outcome. PFTs in current mainstream use cannot reliably assess bleeding risk. These tests have been in use for over a decade, but the hopes raised by PFTs in clinical practice remain unfulfilled. Although physiologically relevant measurement of platelet function now is more important than ever, a critical reappraisal of available techniques in light of clinical requirements is needed. The use of native blood, global stimulus instead of individual agonists, contribution of thrombin generation by activated platelets to the test results, and establishment of a PFT therapeutic range for each antiplatelet drug should be considered and is discussed.

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