title: Optimizing antiplatelet therapy following percutaneous coronary intervention: clinical pathways for platelet function testing.
abstract: Current guidelines recommend dual antiplatelet therapy (DAPT), which includes aspirin         and a platelet P2Y(12) adenosine diphosphate (ADP) receptor antagonist, for treatment of         patients with acute coronary syndrome and following percutaneous coronary intervention         (PCI). Although DAPT significantly reduces stent thrombosis and major adverse         cardiovascular events (MACE), there is considerable interindividual variability in the         degree of platelet inhibition achieved with the most widely used ADP receptor antagonist,         clopidogrel, and high on-treatment platelet activity in the setting of clopidogrel therapy         (hyporesponsiveness) is associated with increased adverse cardiovascular events following         PCI. Personalized tailoring of antiplatelet therapy guided by patient management         algorithms and/or platelet function testing has the potential to reduce MACE and stent         thrombosis. This article outlines specific algorithms for using potent new antiplatelet         agents, such as prasugrel and ticagrelor, and platelet function "test and treat-to-target"         strategies to reduce adverse cardiovascular events following PCI.
authors.affiliation: Department of Medicine, Case Western Reserve School of Medicine, Cleveland, OH, USA.
authors.forename: Tom A
authors.initials: TA
authors.lastname: Lassar
authors.forename: Daniel I
authors.initials: DI
authors.lastname: Simon
authors.forename: Kevin
authors.initials: K
authors.lastname: Croce
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D000465:Algorithms; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D001792:Blood Platelets / Q000187:drug effects*; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D016903:Drug Monitoring / Q000379:methods*; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D010979:Platelet Function Tests; D011237:Predictive Value of Tests; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors