Journal
JACC-CARDIOVASCULAR INTERVENTIONS
Volume 12, Issue 16, Pages 1521-1537Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jcin.2019.03.034
Keywords
genotyping; P2Y(12) receptor inhibitor; platelet function testing; thrombosis
Categories
Funding
- ZonMw
- AstraZeneca
- Abbott
- Daiichi Sankyo
- Boehringer Ingelheim
- Bayer
- Amarin
- Amgen
- Bristol-Myers Squibb
- Chiesi
- Eisai
- Ethicon
- Forest Laboratories
- Idorsia
- Ironwood
- Ischemix
- Eli Lilly
- Medtronic
- PhaseBio
- Pfizer
- Regeneron
- Roche
- Sanofi
- Synaptic
- The Medicines Company
- Boston
- Biosensors
- National Institutes of Health
- Medicure
- Instrumentation Labs
- Haemonetics
- Ionis
- Janssen
- Merck
- Korean Society of Interventional Cardiology
- Han-mi Pharmaceuticals
- Yuhan Daewoong Pharmaceuticals
- Otsuka
- Beth Israel Deaconess
- Bristol-Myers Squibb/Sanofi
- CSL Behring
- Eli Lilly/Daiichi Sankyo
- Novartis
- OrbusNeich
- Janssen Pharmaceuticals
- Osprey Medical
- Watermark Research Partners
- NIH/NHLBI [U01HL128606]
- Quark Pharmaceuticals
- GlaxoSmithKline
- Intarcia
- Janssen Research and Development
- MedImmune
- Poxel
- Takeda
- Roche Diagnostics
- Eli Lilly Canada
- Spartan Biosciences
- Aggredyne
- Diapharma/Roche Diagnostics
- PlaqueTec
- Abbott Vascular
- Biotronik
- Boston Scientific
Ask authors/readers for more resources
Dual-antiplatelet therapy (DAPT) with aspirin and a P2Y(12) receptor inhibitor is the standard treatment for patients undergoing percutaneous coronary intervention. The availability of different P2Y(12) receptor inhibitors (clopidogrel, prasugrel, ticagrelor) with varying levels of potency has enabled physicians to contemplate individualized treatment regimens, which may include escalation or de-escalation of P2Y(12)-inhibiting therapy. Indeed, individualized and alternative DAPT strategies may be chosen according to the clinical setting (stable coronary artery disease vs. acute coronary syndrome), the stage of the disease (early-vs. long-term treatment), and patient risk for ischemic and bleeding complications. A tailored DAPT approach may be potentially guided by platelet function testing (PFT) or genetic testing. Although the routine use of PFT or genetic testing in percutaneous coronary intervention-treated patients is not recommended, recent data have led to an update in guideline recommendations that allow considering selective use of PFT for DAPT de-escalation. However, guidelines do not expand on when to implement the selective use of such assays into decision making for personalized treatment approaches. Therefore, an international expert consensus group of key leaders from North America, Asia, and Europe with expertise in the field of antiplatelet treatment was convened. This document updates 2 prior consensus papers on this topic and summarizes the contemporary updated expert consensus recommendations for the selective use of PFT or genotyping in patients undergoing percutaneous coronary intervention. (c) 2019 by the American College of Cardiology Foundation.
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