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Advances and Perspectives in methods for identifying high platelet reactivity
Hua Gao1,2, Nan Yang2, Libo Yang3
1Department of Pharmacy, General Hospital of Ningxia Medical University, Yinchuan, 750004, China.
Insights
Selecting the right P2Y12 inhibitors is crucial for preventing thrombotic events. This review compares methods like genetic testing and platelet function tests to predict patient response and guide therapy for better outcomes.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Medicine
Background:
- Antiplatelet therapy is essential for preventing ischemic events in cardiovascular and cerebrovascular diseases.
- Poor response to P2Y12 inhibitors poses a significant risk of thrombosis, complicating treatment selection.
- Commonly used P2Y12 inhibitors include clopidogrel, ticagrelor, and prasugrel.
Purpose of the Study:
- To review and analyze methods for predicting high platelet reactivity to P2Y12 inhibitors.
- To guide the rational clinical application of P2Y12 receptor inhibitors based on patient-specific risk factors.
- To avert major adverse cardiovascular and cerebrovascular events (MACCE) through personalized antiplatelet therapy.
Main Methods:
- Summarization of existing identification methods for predicting platelet reactivity.
- Analysis of the advantages and drawbacks of different prediction methods in clinical settings.
- Evaluation of genetic testing, platelet function testing, and risk scores.
Main Results:
- Various methods exist to predict platelet reactivity and P2Y12 inhibitor response.
- Each method (genetic, functional, risk scores) has unique strengths and limitations for clinical use.
- Predictive assessment is key to optimizing antiplatelet therapy and reducing MACCE.
Conclusions:
- Accurate prediction of P2Y12 inhibitor response is vital for effective antiplatelet therapy.
- Understanding the pros and cons of different predictive methods aids clinical decision-making.
- Personalized selection of P2Y12 inhibitors can improve patient outcomes and reduce thrombotic risks.
Abstract:
Antiplatelet therapy is the foundational treatment for the prevention and treatment of coronary and cerebrovascular ischemic events in patients with coronary heart disease, ischemic stroke, and transient ischemic attack (TIA). However, with more and more studies reporting an increased risk of thrombosis in some patients due to poor response to therapeutic agents, the selection of appropriate P2Y12 inhibitors has become a major challenge that needs to be addressed urgently. Currently, commonly used oral P2Y12 inhibitors include clopidogrel, ticagrelor, and prasugrel. Assessing patients' risk factors before the development of treatment regimens by effectively predicting the risk of high platelet reactivity with specific P2Y12 inhibitors in advance to avert the occurrence of major adverse cardiovascular and cerebrovascular events (MACCE) is the key point to the problem. Up to now, methods available for predicting platelet reactivity include genetic testing, platelet function testing, and risk scores. This review provides a summarization of the existent available identification methods and analyzes the advantages and drawbacks of different methods in specific clinical settings, intending to guide the rational clinical application of P2Y12 receptor inhibitors.
