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The use of the VerifyNow system to monitor antiplatelet therapy: a review of the current evidence.

机译：使用VerifyNow系统监控抗血小板治疗：对当前证据的回顾。

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Multiple studies have demonstrated the effectiveness of dual or triple antiplatelet therapy with aspirin, clopidogrel and glycoprotein (GP) IIb/IIIa therapy in patients with acute coronary syndromes as well as in patients undergoing coronary stent implantation. In the last few years, it is becoming clear that not all patients receive the full benefits with the current standard dosages of antiplatelet therapy. Specifically, numerous studies have revealed a wide interindividual variability in the response to these antiplatelet agents and, more importantly, both nonresponsiveness as well as a heightened residual platelet reactivity have been linked to the occurrence of adverse cardiovascular events. Therefore, assays that identify those patients with an impaired responsiveness or a heightened platelet reactivity despite dual antiplatelet therapy may contribute to better risk stratification and will probably improve clinical outcome when appropriate action is initiated. Likewise, a considerable number of patients do not achieve the minimal inhibition of aggregation threshold with the current recommended weight-adjusted dosages of GP IIb/IIIa therapy. Identifying and optimizing the absolute degree of platelet inhibition in this subgroup of patients will probably improve clinical outcome. The VerifyNow platform is one of the most user friendly point-of-care platelet function test systems because it produces rapid results at the patient bedside. The purpose of the present paper is to give insight into the principal mechanisms of the VerifyNow system, to discuss its clinical utility for the monitoring of antiplatelet therapy and to discuss the proposed cut-off levels to segregate responders from non-responders for the different types of antiplatelet therapy.
机译：多项研究表明，阿司匹林，氯吡格雷和糖蛋白（GP）IIb / IIIa双重或三重抗血小板治疗在患有急性冠脉综合征的患者以及接受冠状动脉支架植入术的患者中均有效。在过去的几年中，越来越明显的是，并不是所有的患者都能从当前标准剂量的抗血小板治疗中获得全部收益。具体而言，大量研究表明，对这些抗血小板药的反应存在较大的个体差异，更重要的是，无反应性以及残留血小板反应性的升高均与不良心血管事件的发生有关。因此，即使采用双重抗血小板治疗，仍能识别出反应性受损或血小板反应性升高的患者的测定方法可能有助于更好地进行风险分层，并且在采取适当行动后可能会改善临床疗效。同样，在目前推荐的GP IIb / IIIa治疗体重调整剂量下，相当多的患者未达到对聚集阈值的最小抑制作用。在这一亚组患者中确定和优化血小板抑制的绝对程度可能会改善临床结局。 VerifyNow平台是最用户友好的即时护理血小板功能测试系统之一，因为它可以在患者床边快速产生结果。本文的目的是深入了解VerifyNow系统的主要机制，讨论其在监测抗血小板治疗中的临床效用，并讨论将不同类型的反应者与非反应者分开的建议临界水平。抗血小板治疗。

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