Key result
PFT-guided antiplatelet therapy shows potential in cerebral infarction, but robust trial evidence remains lacking.
Why the study?
Although platelet function testing (PFT)-guided antiplatelet therapy is beneficial post-PCI, its efficacy in cerebral infarction remains controversial with considerable variability in clinical application.
Does platelet function testing-guided individualized antiplatelet therapy reduce ischemic and bleeding events in patients with cerebral infarction?
Does platelet function testing-guided individualized antiplatelet therapy reduce ischemic and bleeding events in patients with cerebral infarction?
While PFT-guided precision antiplatelet therapy offers a promising approach to balance ischemic and bleeding risks in stroke patients, its routine clinical application requires validation through high-quality randomized trials.
Answers are grounded in this paper and cite their sources.
PFT-guided antiplatelet therapy should not yet inform stroke management; leaves open whether it reduces ischemic or bleeding events.
Current evidence indicates that antiplatelet therapy as a cornerstone for secondary prevention of cerebral infarction. However, ischemic or bleeding events arising from antiplatelet drug resistance or excessive platelet inhibition can diminish its clinical benefit. These challenges have laid the foundation for individualized antiplatelet treatment. Although cytochrome P450 family 2 subfamily C member 19 ( CYP2C19 ) genetic polymorphisms have partially addressed the issue of drug resistance in these patients, they remain insufficient to resolve the high incidence of both ischemic and bleeding events. Platelet function testing (PFT)‐guided antiplatelet therapy has been proven beneficial in patients after percutaneous coronary intervention, yet its efficacy in patients with cerebral infarction remains controversial. Platelet function provides a direct and comprehensive reflection of antiplatelet effects, offering potential not only to overcome drug resistance but also to guide de‐escalation strategies, thereby mitigating the frequent occurrence of both ischemic and bleeding events in cerebral infarction. Overall, the current application of PFT to guide personalized antiplatelet regimens in patients with cerebral infarction is characterized by considerable variability. In light of recent advances in this field, we herein review the current landscape of PFT‐guided individualized antiplatelet therapy in cerebral infarction, with the aim of summarizing existing evidence and offering suggestions for future research.
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Zhu et al. (2026) conducted a review in Cerebral infarction and transient ischemic attack (TIA). Platelet function testing (PFT)-guided precision antiplatelet therapy vs. Standard guideline-based antiplatelet therapy was evaluated. Platelet function testing-guided precision antiplatelet therapy shows potential for optimizing treatment in cerebral infarction, but robust evidence from high-quality randomized controlled trials is currently lacking.
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