Why the study?
A sizeable proportion of PCI patients have impaired or unwarranted responses to DAPT due to genetic polymorphisms or platelet response variability, leading to the introduction of guided DAPT.
Does guided DAPT based on platelet function or genetic testing improve outcomes in patients undergoing percutaneous coronary intervention?
Does guided DAPT based on platelet function or genetic testing improve outcomes in patients undergoing percutaneous coronary intervention?
This review provides a comprehensive overview of modulating dual antiplatelet therapy using platelet function or genetic testing to balance thrombotic and bleeding risks in patients undergoing PCI.
Guided DAPT testing may help balance risks in PCI; leaves open whether it improves outcomes pending definitive trials.
Dual antiplatelet therapy (DAPT) is the standard approach to prevent thrombotic events in patients undergoing percutaneous coronary intervention and presenting with chronic or acute coronary syndromes. However, a sizeable proportion of patients presents with an impaired or unwarranted response to DAPT depending on genetic polymorphisms or variability in platelet response. Therefore, the concept of changing the type or dose of antiplatelet drugs based on the result of platelet function or genotype tests (ie, guided DAPT) has been introduced. The goal of guided DAPT is to intensify the antiplatelet potency in patients at high risk of thrombotic events (ie, escalation) and to decrease the antiplatelet potency in patients at high risk of bleeding (ie, de-escalation). This review aims to present an up-to-date and comprehensive overview of the latest research findings on DAPT modulation guided by either platelet function or genetic testing, discussing its current indications and future directions.
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Ammirabile et al. (2023) studied this question.
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