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Updated: Apr 21, 2026
Dynamic Multiparameter Platelet Function Assessment Using a Capacitive Biosensor
Published on: May 2, 2025
Personalized antiplatelet therapy: a scoping review on the role of platelet function testing and genotyping in acute
Jeenal Venissa Rebello1, Ashna Shah1, Mohammed Salim Karattuthodi1
1Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India.
Insights
Platelet Function Tests (PFTs) and genetic testing can guide antiplatelet therapy for acute coronary syndrome (ACS). However, challenges like standardization and variability limit their routine use in precision medicine.
Area of Science:
- Cardiology
- Pharmacogenomics
- Clinical Trials
Background:
- Acute coronary syndrome (ACS) is a major cause of death globally, with antiplatelet therapy as a standard treatment.
- Patient response to antiplatelet agents varies due to factors like comorbidities and genetic differences, complicating treatment optimization.
Purpose of the Study:
- To identify facilitators and challenges in using Platelet Function Tests (PFTs) and genotype-guided antiplatelet therapy for ACS.
- To review existing literature on PFTs and genetic testing in ACS management.
Main Methods:
- A scoping review using Arksey and O'Malley's framework.
- Searched PubMed, Embase, and Scopus for articles published between 2010 and 2025.
- Included 346 studies with diverse designs, patient populations, and outcomes.
Main Results:
- Facilitators for PFT use include risk stratification for bleeding and ischemic events.
- Key challenges include lack of assay standardization, result discordance, and variability across testing modalities.
- Evidence linking genetic polymorphisms to clinical outcomes remains variable.
Conclusions:
- PFTs and genotyping show potential for tailoring antiplatelet therapy in ACS.
- Heterogeneity and practical challenges currently limit routine clinical application.
- Further outcome-driven studies and standardized protocols are needed for precision-guided ACS therapy.
Background:
Acute coronary syndrome (ACS) remains a leading cause of global morbidity and mortality, often managed with antiplatelet therapy. However, variability in patient response due to comorbidities, genetic polymorphisms, and resistance to antiplatelet agents creates challenges in optimizing treatment.
Methods:
The scoping review was conducted using Arksey and O'Malley's five-step framework to identify facilitators and challenges influencing the use of Platelet Function Test (PFT) and genotype-guided antiplatelet therapy for ACS. PubMed, Embase, and Scopus were utilized for identifying the relevant articles published between 2010 and 2025.
Results:
A total of 346 studies was included, with sample sizes ranging from 13 to 10,048 patients. The included studies showed heterogeneity in study design, sample size, follow-ups, PFT techniques and in outcomes. The articles had predominantly male patients with various comorbidities. The PFTs identified included VerifyNow, light transmission aggregometry (LTA), vasodilator-stimulated phosphoprotein (VASP), multiplate, thromboelastography (TEG) etc. The facilitating factors for PFT included risk stratification for bleeding and ischemic events and treatment adjustments in high-risk groups. Whereas the key challenges identified were lack of assay standardization, discordance between test results, and variability across testing modalities. Although the association between treatment response and genetic polymorphisms were frequently reported, evidence for clinical outcome remains variable and uncertain.
Conclusion:
Existing evidence shows that PFT and genotyping may provide significant findings for tailoring antiplatelet therapy in ACS. However the heterogeneity and practical challenges limit their routine use. Further, well-designed outcome driven studies and standardised protocols are required to define their role in precision guided therapy for ACS management.
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