The use of platelet function testing in PCI and CABG patients

Antiplatelet drugs are widely used in the treatment of patients with coronary artery disease. Dual anti-platelet therapy with acetylsalicylic acid (ASA) and a P2Y12 inhibitor (clopidogrel, prasugrel or ticagrelor) is the recommended strategy for patients undergoing a percutaneous coronary intervention (PCI), while patients that undergo coronary artery bypass grafting (CABG) are treated with ASA monotherapy. However, the response to these drugs as assessed with platelet function tests varies between patients. Despite these drugs, many patients still exhibit high on-treatment platelet reactivity (HPR), while platelet reactivity seems to be excessively inhibited in other patients. This review will discuss the use of platelet function testing in the prediction of atherothrombotic and bleeding events in patients undergoing PCI or CABG. Furthermore, options for tailoring based on platelet function testing in these patients are described.