Role of platelet function and genetic testing in patients undergoing percutaneous coronary intervention

Dual antiplatelet therapy (DAPT) represents the standard of care for patients undergoing percutaneous coronary intervention (PCI). Increasing evidence indicates that a one-size-fits-all approach with the use of a standard DAPT regimen for all patients undergoing PCI could lead to either suboptimal efficacy or prohibitively high bleeding in specific cohorts of patients. Moreover, the broad interindividual variabil-ity in response to P2Y12 inhibitors can impact outcomes and resource utilization. Among the strategies proposed to provide a more balanced trade-off between bleeding and ischemic events at a single pa-tient level, a guided selection of P2Y12 inhibitors, by using platelet function or genetic testing, has shown promising results. In this review, we provide a focused summary of the rationale and evidence on the use of platelet function and genetic testing-guided antiplatelet therapy, and we explore the implications for their use in the modern setting of patients undergoing PCI.(c) 2021 Elsevier Inc. All rights reserved.

Automated summary

Dual antiplatelet therapy (DAPT) is the standard treatment for patients undergoing percutaneous coronary intervention (PCI). However, using a standard DAPT regimen for all patients could result in suboptimal efficacy or high bleeding risk for certain individuals. Guided selection of P2Y12 inhibitors based on platelet function or genetic testing has shown promising results in achieving a better balance between bleeding and ischemic events at the individual patient level. This review focuses on the rationale and evidence for platelet function and genetic testing-guided antiplatelet therapy and explores their implications in the modern setting of patients undergoing PCI.