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Personalized Approaches to Antiplatelet Treatment for Cardiovascular Diseases: An Umbrella Review

Angelo Oliva1,2, Davide Cao1,3, Alessandro Spirito1

  • 1The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.

Pharmacogenomics and Personalized Medicine
|November 9, 2023
PubMed

Insights

Personalized antiplatelet therapy balances bleeding and ischemic risks in atherosclerosis patients. Novel strategies and risk assessment tools optimize antithrombotic management for better clinical outcomes.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Pharmacology

Background:

  • Antiplatelet therapy is crucial for preventing thrombotic events in atherosclerosis but increases bleeding risk.
  • Balancing antithrombotic benefits with bleeding risks is essential for patient outcomes.
  • Personalized strategies are needed to optimize treatment for individual risk profiles.

Purpose of the Study:

  • To review current evidence on antiplatelet strategies for cardiovascular disease.
  • To outline risk-stratification tools for tailoring antithrombotic management.
  • To discuss novel approaches for optimizing net clinical benefit.

Main Methods:

  • Review of current scientific literature on antiplatelet therapy and antithrombotic strategies.
  • Analysis of risk scores, consensus definitions, and artificial intelligence tools.
  • Evaluation of platelet function and genetic testing for personalized management.
  • Assessment of novel therapeutic strategies including dual pathway inhibition.

Main Results:

  • Personalized antithrombotic strategies aim to maximize net clinical benefit by considering individual bleeding and ischemic risks.
  • Risk scores, platelet function testing, and AI tools aid in tailoring therapy.
  • Novel strategies include P2Y12 inhibitor monotherapy, parenteral agents, and dual pathway inhibition.

Conclusions:

  • Integrated approaches using risk stratification and novel strategies are key to personalized antithrombotic management.
  • Tailored antiplatelet therapy can improve outcomes in patients with cardiovascular disease.
  • Optimizing antithrombotic treatment requires a comprehensive assessment of individual patient profiles.

Keywords:
P2Y12 inhibitorantiplatelet therapyaspirincardiovascular disease

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