Prof. Dr. med. Dirk Sibbing, MHBA, FESC
Oberarzt, Medizinische Klinik und Poliklinik I
Ludwig-Maximilians-Universität (LMU) München
Chairperson ESC Working Group on Thrombosis
MedicalResearch.com: What is the background for this consensus statement? What are the main findings that led to these conclusions?
Response: The availability of different P2Y12 receptor inhibitors (clopidogrel, prasugrel, ticagrelor) with varying levels of potency has enabled physicians to contemplate individualized treatment concepts. Such concepts may include escalation or de-escalation of P2Y12 inhibiting therapy.
Alternative DAPT strategies may be chosen according to the clinical setting (stable coronary artery disease vs. acute coronary syndrome), the stage of the disease (early vs. chronic treatment) and patient risk for ischemic and bleeding complications. As always in clinical medicine, guidance by means of biomarkers or risk scores is always helpful and warranted. Here specifically, a tailored DAPT approach may be potentially guided by platelet function (PFT) or genetic testing. Continue reading →
Martine Jandrot-Perrus MD, PhD. Emeritus Research Professor
Inserm University Paris Diderot
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Blood platelets are key actors in thrombosis a leading cause of global mortality estimated to account for 1 in 4 death worldwide in 2010.
Thrombosis is associated with cardiovascular diseases (myocardial infarction, stroke, lower limb ischemia, venous thromboembolism), and with numerous pathologies such as cancer, infections or inflammatory diseases. Currently available antiplatelet drugs are the cornerstone of therapy for patients with acute coronary syndromes. However, these drugs all carry an inherent risk of bleeding that restricts their use in sensitive populations and when arterial thrombosis occurs in the cerebral territory. At present the only acute treatment option available for ischemic stroke consists in revascularization by thrombolysis, and/or mechanical thrombectomy. But the number of patients eligible to these treatments is low (» 15% of all patients) and the success rate does not exceed 50%. The responsibility of platelets in the failure for thrombolysis / thrombectomy to restore vascular patency is strongly suspected.
There is thus a clear medical need for new antiplatelet drugs with an improved safety profile. We set out to develop ACT017, a novel, first in class, therapeutic antibody to platelet glycoprotein VI with potent and selective antiplatelet effects. The interest of GPVI resides in the fact that it’s a receptor involved in the development of occlusive thrombi but that it is not strictly required for physiological hemostasis. Continue reading →
Mei X. Wu, Ph.D.
Wellman Center for Photomedicine
Massachusetts General Hospital
Harvard Medical School
MedicalResearch.com: What is the background for this study?
Response: An abnormally low count of platelets, a disorder called thrombocytopenia, is life-threatening owing to a high risk of uncontrollable bleeding. The disorder can be caused by a variety of conditions like trauma, an autoimmune disorder that attacks platelets, side-effects of some drugs especially chemotherapeutic drugs, and in premature newborns and patients with HIV-infection or a genetic defect leading to insufficient platelet generation. Platelet transfusion is the most effective modality to treat the disorder, but it is associated with complications including allergic reaction, fever, infection, and immunosuppression and limited only to the most severe patients. Several FDA-approved drugs are currently used in the clinics or clinical trials to increase platelet levels, which however must be carefully dosed to avoid excessive platelet production that is also dangerous and are not suitable to many forms of thrombocytopenia.
Medical Research: What are the main findings of the study?
Dr. Mayer:Patients whose platelets do not respond well to aspirin carry a higher risk of death or stent thrombosis. Platelet response to aspirin is an independent predictor of ischemic events in patients undergoing percutaneous coronary interventions (PCI). Continue reading →
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