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Abhishek Kumar, MBBS, MRCP; David H. Roberts, MD, FRCP

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

This commendable work by O’Riordan et al¹ will undoubtedly be an invaluable guide for surgeons. However, due to variable individual response to clopidogrel,² the decision to stop treatment with clopidogrel should be based on the level of platelet inhibition. Such patients can be identified and monitored using simple bedside assay.³ This variability in the antiplatelet activity of clopidogrel can be attributed to genetic polymorphism.⁴ Thus, those with low responses to clopidogrel whose bleeding risks are minimal but who are at higher risk of further major cardiovascular events⁵ can be offered surgery early, and potentially fatal cardiovascular complications can be avoided.

Due to the problems related to variable responses to clopidogrel, novel P2Y12 antagonists, like prasugrel, ticagrelor, and cangrelor, with more potent antiplatelet effects are emerging. Although these agents cause higher degrees of platelet inhibition, this may come at the cost of . . . [Full Text of this Article]

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RELATED LETTER

Test Before You Stop—Reply
James M. O’Riordan, Ronan J. Margey, Gavin Blake, and P. Ronan O’Connell
Arch Surg. 2009;144(8):787.
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RELATED ARTICLE

Antiplatelet Agents in the Perioperative Period
James M. O’Riordan, Ronan J. Margey, Gavin Blake, and P. Ronan O’Connell
Arch Surg. 2009;144(1):69-76.
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