Platelet-Function Testing Has No Benefit in Coronary Stenting

Findings from the ARCTIC trial freeze the monitoring-guided approach in its tracks.

Much debate has surrounded the potential benefit, before and after stenting, of platelet-function testing and correspondingly tailored antiplatelet therapy. In a multicenter, open-label trial from France, 2440 patients about to undergo coronary stenting were randomized to one of two strategies:

Monitoring-guided: platelet-function testing with the VerifyNow assay; patients with inadequate inhibition had their antiplatelet drugs (intravenous aspirin, clopidogrel, or prasugrel) and doses adjusted
Conventional: no platelet-function testing or corresponding drug adjustment

About 35% of the monitoring group had high platelet reactivity before stenting; 80% of those patients received an additional loading dose of clopidogrel, and 3% received additio…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI