Platelet Function Testing and Genotyping for Tailoring Treatment in Complex PCI Patients

Area of Science:

• Cardiology
• Pharmacology

Background:

• Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor is standard post-percutaneous coronary intervention (PCI).
• Complex PCI (C-PCI) patients face higher ischemic risks, complicating DAPT strategy selection.
• Balancing ischemic and bleeding risks in C-PCI necessitates individualized DAPT approaches.

Purpose of the Study:

• To critically evaluate the utility of platelet function testing and genotyping for tailoring DAPT in C-PCI patients.
• To review current evidence on personalized antiplatelet therapy in this specific subpopulation.

Main Methods:

• Literature review of clinical trials and studies.
• Analysis of evidence regarding platelet function testing and genotyping in C-PCI patients.
• Assessment of treatment individualization strategies for DAPT.

Main Results:

• Existing trials on platelet function testing and genotyping in PCI populations show conflicting and largely neutral results.
• The role of these tools for optimizing DAPT in C-PCI remains uncertain due to limited dedicated research.
• Individualization of DAPT potency and duration is an evolving strategy for C-PCI.

Conclusions:

• Current evidence is insufficient to definitively recommend platelet function testing or genotyping for guiding DAPT in C-PCI patients.
• Further dedicated studies are required to establish the clinical utility of these personalized approaches.
• Optimizing antiplatelet therapy in C-PCI remains an area needing further investigation.