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Monitoring the effectiveness of antiplatelet therapy: opportunities and limitations.

ABSTRACT: Previous clinical studies have shown heterogeneity in individual patient responses to antiplatelet therapy and high residual platelet reactivity is associated with increased risk of adverse clinical events. Monitoring response to antiplatelet therapy and tailoring treatment accordingly is currently not recommended in routine clinical practice largely due to the lack of a standardized definition of antiplatelet therapy hyporesponse and the need for a widely accepted point-of-care platelet function test that can be reliably utilized in frontline clinical practice. Recent data have shown that titrating the dose of clopidogrel in patients undergoing percutaneous coronary intervention significantly reduces the incidence of major adverse cardiovascular events and large-scale clinical trials are currently underway to investigate whether individually tailored treatment based on results of platelet function testing leads to improved clinical outcome. Furthermore, genetic testing has demonstrated a link between CYP2C19 genetic polymorphisms, altered clopidogrel metabolite concentrations and adverse clinical events. Clinical studies are currently underway to investigate the potential clinical benefit associated with genotype-guided tailoring of antiplatelet therapy. With the advent of newer, more potent antiplatelet agents and their associated increased bleeding risks, it will become imperative in the future to select the most appropriate, safe and effective drug.

SUBMITTER: Sambu N

PROVIDER: S-EPMC3195743 | biostudies-other | 2011 Oct

REPOSITORIES: biostudies-other

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Monitoring the effectiveness of antiplatelet therapy: opportunities and limitations.

Sambu Nalyaka N Curzen Nick N

British journal of clinical pharmacology 20111001 4

Previous clinical studies have shown heterogeneity in individual patient responses to antiplatelet therapy and high residual platelet reactivity is associated with increased risk of adverse clinical events. Monitoring response to antiplatelet therapy and tailoring treatment accordingly is currently not recommended in routine clinical practice largely due to the lack of a standardized definition of antiplatelet therapy hyporesponse and the need for a widely accepted point-of-care platelet functio ...[more]

PMID: 21366666

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Project description:BackgroundRecently there has been increasing focus on monitoring pollinating insects, due to concerns about their declines, and interest in the role of volunteers in monitoring pollinators, particularly bumblebees, via citizen science.Methodology / principal findingsThe Big Bumblebee Discovery was a one-year citizen science project run by a partnership of EDF Energy, the British Science Association and the Centre for Ecology & Hydrology which sought to assess the influence of the landscape at multiple scales on the diversity and abundance of bumblebees. Timed counts of bumblebees (Bombus spp.; identified to six colour groups) visiting focal plants of lavender (Lavendula spp.) were carried out by about 13 000 primary school children (7-11 years old) from over 4000 schools across the UK. 3948 reports were received totalling 26 868 bumblebees. We found that while the wider landscape type had no significant effect on reported bumblebee abundance, the local proximity to flowers had a significant effect (fewer bumblebees where other flowers were reported to be >5m away from the focal plant). However, the rate of mis-identifcation, revealed by photographs uploaded by participants and a photo-based quiz, was high.Conclusions / significanceOur citizen science results support recent research on the importance of local flocal resources on pollinator abundance. Timed counts of insects visiting a lure plant is potentially an effective approach for standardised pollinator monitoring, engaging a large number of participants with a simple protocol. However, the relatively high rate of mis-identifications (compared to reports from previous pollinator citizen science projects) highlights the importance of investing in resources to train volunteers. Also, to be a scientifically valid method for enquiry, citizen science data needs to be sufficiently high quality, so receiving supporting evidence (such as photographs) would allow this to be tested and for records to be verified.

Dataset Information

Monitoring the effectiveness of antiplatelet therapy: opportunities and limitations.

Publications

Monitoring the effectiveness of antiplatelet therapy: opportunities and limitations.

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