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August 14, 2026Neuroprotection/Neuroprotection (Chichester, England. Print)Open Access

Current status and future perspectives of platelet function‐guided precision antiplatelet therapy for patients with cerebral infarction

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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 (PFT)-guided antiplatelet therapy reduce ischemic and bleeding events in patients with cerebral infarction?

Design

Review

Key result

Platelet function testing-guided antiplatelet therapy offers potential to overcome drug resistance and guide de-escalation strategies in patients with cerebral infarction.

Authors

GZGuoliang ZhuXCXiaoling ChenXHXinyi Huang

Discussion

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Overview

CYP2C19-guided antiplatelet dosing may reduce ischemic events after stroke; leaves open prospective trials for bleeding risk and non-genetic factors.

Key Points

  • To review the current clinical evidence, challenges, and future perspectives of platelet function testing-guided individualized antiplatelet therapy for secondary prevention of cerebral infarction.
  • Reviewed published literature on antiplatelet resistance, CYP2C19 genetic polymorphism testing, and platelet function testing in patients with cerebral infarction and percutaneous coronary intervention.
  • CYP2C19 genetic testing partially addresses antiplatelet drug resistance but remains insufficient to fully eliminate ischemic recurrence and bleeding complications.
  • Platelet function testing directly assesses antiplatelet responsiveness to identify resistance or excessive inhibition, but its efficacy in stroke care remains controversial and variable compared to cardiac intervention.
  • Platelet function-guided strategies provide a framework for dose escalation or de-escalation to balance ischemic and bleeding risks in individualized stroke management.

Structured PICO

Does platelet function testing (PFT)-guided antiplatelet therapy reduce ischemic and bleeding events in patients with cerebral infarction?

P
Population
Patients with cerebral infarction
I
Intervention
Platelet function testing (PFT)-guided antiplatelet therapy

PFT-guided antiplatelet therapy offers a potential strategy to individualize treatment and reduce both ischemic and bleeding events in patients with cerebral infarction, though its current application remains variable.

Cite This Study

Zhu et al. (2026) conducted a review in cerebral infarction. Platelet function testing (PFT)-guided antiplatelet therapy was evaluated. Platelet function testing-guided antiplatelet therapy offers potential to overcome drug resistance and guide de-escalation strategies in patients with cerebral infarction.

synapsesocial.com/papers/6a7ec79cb70b84ec8b914244https://doi.org/10.1002/nep3.70057
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