Progress Analysis of Personalized Antiplatelet Therapy in Patients with Coronary Heart Disease Undergoing...

Area of Science:

• Cardiology
• Pharmacology
• Vascular Medicine

Background:

• Coronary atherosclerosis (coronary heart disease, CHD) is a prevalent cardiovascular disease with significant health impacts.
• Percutaneous coronary stent implantation is a primary treatment for severe CHD, often accompanied by dual antiplatelet therapy (DAPT) to prevent thrombosis.
• High on-treatment platelet reactivity (HTPR), or antiplatelet resistance, occurs in some patients despite DAPT, posing a risk for stent thrombosis.

Purpose of the Study:

• To review the mechanisms of action of current antiplatelet drugs.
• To discuss the rationale for personalized antiplatelet therapy in CHD patients.
• To explore methods for screening antiplatelet reactions and the development of novel antiplatelet agents.

Main Methods:

• Review of existing literature on antiplatelet drug mechanisms.
• Analysis of clinical studies on high on-treatment platelet reactivity (HTPR).
• Discussion of screening methods and emerging antiplatelet therapies.

Main Results:

• Current antiplatelet drugs like aspirin and clopidogrel have unclear mechanisms, leading to variable patient responses.
• High on-treatment platelet reactivity (HTPR) is a recognized clinical challenge in patients undergoing DAPT after stenting.
• Ticagrelor, indobufen, and rivaroxaban are identified as common, safe, and promising antiplatelet options.

Conclusions:

• Personalized antiplatelet therapy is essential for managing CHD and preventing stent thrombosis.
• Screening for high on-treatment platelet reactivity (HTPR) is necessary for optimizing treatment.
• Further research into novel antiplatelet drugs is warranted to improve patient outcomes.