China has reached a leading level in platelet function testing technology and clinical application research!
The theory that platelet function is closely related to thrombosis has a solid theoretical foundation and has undergone long-term and extensive verification and confirmation in clinical practice, which is completely correct. Therefore, in recent years, the application of platelet function testing to guide clinical thrombosis prevention and treatment has become a hot spot in the international medical community. Scholars and experts from various countries have carried out a large number of related studies, expecting to establish an individualized and precise model for clinical antiplatelet therapy based on platelet function testing. However, in recent years, several large-scale clinical trials on the correlation between platelets and thrombosis conducted by some European and American experts have been declared "failed", and some similar studies by domestic scholars have also "failed". As a result, some scholars at home and abroad have become skeptical and pessimistic about the value of platelet function testing, and the road to precise antiplatelet therapy seems to be uncertain. However, two large-scale clinical trials completed by Chinese scholars and announced at the 2016 China Stroke Conference in May this year confirmed that the level of platelet function (high or low) is significantly correlated with the occurrence of clinical thrombotic events, which is completely consistent with the relevant theories. The success of these two studies has set a good example for the correct application of platelet function testing.
Why do these different trials draw completely different conclusions? How to explain the "failure" of similar studies in Europe and America? For this reason, the author has studied and analyzed several relevant clinical trials published in recent years. We believe that the success and "failure" of the published clinical research results on the correlation between platelet function and thrombosis at home and abroad have well interpreted the existing theory on the correlation between platelet function and thrombosis. The "failure" of some clinical studies, however, exposes that some scholars have a one-sided or even wrong understanding of the theory related to platelet function, which is specifically reflected in: incorrect design of trial protocols, wrong and inappropriate analysis of trial data, etc. Since these wrong views even come from some international medical authorities, their influence is great, seriously hindering and interfering with the correct and normal clinical application of platelet function testing technology, and seriously impeding the progress of antiplatelet therapy along the correct path of precision and individualization.
From the analysis of the above data, we should draw the following conclusions:
Only multi-parameter testing can truly reflect the functional status of platelets, while testing a single platelet function receptor cannot represent the overall functional status of platelets.
In the Trilogy, Aratic and Antarctic studies, only the functional level of a single ADP receptor of platelets was tested in patients, and the functional levels of other platelet receptors were not tested. Therefore, these three trials all attempted to represent and reflect the overall platelet function level of patients through the functional level of a single ADP receptor of platelets, which is obviously very wrong. This is as absurd as expecting patients to obtain the efficacy of aspirin by simply taking clopidogrel.
The Trilogy, Aratic and Antarctic studies cannot deny the existing research results on platelet function and the theory of its correlation with thrombosis. On the contrary, these three trials have well confirmed that the existing theories on platelet function and its role in thrombosis are completely correct. According to the existing theories, the correct and accurate conclusion of these three studies should be rewritten as: "Using the VerifyNow instrument to simply detect ADP receptor function did not find a significant correlation between ADP receptor function level and thrombotic events". However, the conclusion that "platelet function level is not related to thrombotic events" based on these three trials is contrary to the relevant theories and objective reality, and is wrong. These three trials all reflect that the relevant researchers lack a comprehensive and correct understanding of the theories related to platelet function.
In view of the particularity of platelet function testing, not only the trial protocol needs to be correctly and reasonably designed, but also the quality control of test samples, the standardization of the testing process, and the selection of testing methods in the trial are likely to be factors leading to the "failure" of the trial. The two successful clinical trials completed by Chinese scholars were more scientific and reasonable in terms of protocol design, selection of testing methods, and control of the trial process, so it is not surprising that the studies achieved success.
The research results of Chinese scholars show that China has reached a leading level in the clinical application of platelet function testing technology and the research on platelet function testing technologies and methods, which proves the professional level and strength of Chinese scholars in this field!
It is hoped that Chinese scholars will continue their efforts to popularize and apply the successful experience gained to the clinical prevention and treatment of thrombotic diseases as soon as possible, so as to make greater contributions to the effective prevention and treatment of thrombotic diseases in China and around the world.
Jiangsu Innova Medical Technology Co., Ltd.
