International Circulation: There has been controversy on platelet function testing in recent years. Do you think antiplatelet therapy should been under the monitoring of platelet function? Do you think these tests should be used to judge the use of antiplatelet therapy?
　　Dr. Dean: If you read the guidelines， they are not a Class I indication and there are several reasons for that. First of all， platelet function testing can be done at the bedside， others require a more laboratory-type of approach. If you are going to perform a sophisticated assessment， then the laboratory is better than the bedside. Having said all that， we do not have clear data suggesting an impact on outcome. Using platelet function testing to determine patient treatment lacks outcome data that shows benefit down the line.
　　Even here， there is a lot of use of clopidogrel in China and there is some pharmacokinetic reason to be concerned about this. The Asian population has some differences in their genetic coding for the proteins that are involved and they are more likely to be resistant to clopidogrel. Some of the newer anti-platelet drugs， which are unfortunately more expensive， are probably better. However， the use of clopidogrel， because it is so widely available， is certainly better than not using dual anti-platelet therapy at all， even with drug metabolism issues in the Asian population.
　　《国际循环》：近年来对血小板功能检测存在争议。您认为抗血小板治疗时是否需检测血小板功能？是否需行血小板功能检测判定疗效？
　　Dean教授：指南中，检测血小板功能并不是Ⅰ类推荐。血小板功能检测可在床边完成，其他检查则需在实验室进行。如果你想做一个复杂评估，实验室检查比床边检查更好。此外，对于血小板检测对转归的影响，目前我们还没有明确的数据。根据血小板功能检测来决定患者的治疗还缺乏显示长期获益的转归数据。
　　在中国，氯吡格雷的应用很广泛，对此有一些药理学方面的担忧。亚洲人群氯吡格雷代谢相关蛋白基因编码有别于其他人群，更容易出现氯吡格雷抵抗。一些新型抗血小板药物可能更好，但价格较贵。然而，由于氯吡格雷容易买到，即使亚洲人群存在氯吡格雷代谢相关的问题，应用氯吡格雷比不用双联抗血小板治疗好。