4.5 Review

Platelet function assays for the diagnosis of aspirin resistance

Journal

PLATELETS
Volume 33, Issue 3, Pages 329-338

Publisher

TAYLOR & FRANCIS INC
DOI: 10.1080/09537104.2021.1942816

Keywords

Aspirin; blood platelets; drug resistance; platelet function tests; venous thromboembolism

Funding

  1. Metro South Health Research Support Scheme

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Aspirin is commonly used for various indications, but assessing platelet function for aspirin resistance is important. Platelet function tests are not widely used in clinical practice and there is a lack of basic understanding of these tests. Understanding platelet assays to determine aspirin resistance is crucial for clinicians.
Aspirin, an antiplatelet drug, is commonly used at low doses for numerous indications, including prophylaxis of cardiovascular, neurovascular, and venous thromboembolic events. Due to review articles suggesting that aspirin resistance may result in poorer outcomes, interest in assessing platelet function is increasing. Despite this, platelet function tests are rarely used as part of routine clinical practice and therefore, a basic understanding of these tests may be lacking. Although aspirin resistance can be categorized as clinical or laboratory resistance, determining laboratory resistance is the only way to determine resistance before treatment failure occurs. Therefore, knowledge of platelet assays to determine aspirin resistance is of importance. The following review aims to provide a framework for clinicians to understand the main principles of platelet function tests. This includes comparison of the most frequently used platelet assays to diagnose aspirin resistance, including the basic mechanism, methodology, reference ranges, inter-assay comparison, and their respective clinical considerations when using.

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