Personalized antiplatelet therapy in patients with coronary artery disease: past, present and future

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Dual-antiplatelet therapy (DAPT) with aspirin and P2Y12-receptor inhibitor is a standard treatment for patients undergoing percutaneous coronary intervention (PCI). History of personalized antiplatelet therapy based on platelet function testing or genetic testing allows choosing individual treatment schemes involving escalation and de-escalation especially in patients with high risk of thrombotic events (recent acute coronary syndrome). In recent years, short-term DAPT under control of residual platelet reactivity has become important after PCI in patients with high risk of hemorrhagic complications. This approach reduces the incidence of hemorrhagic events. The authors present evolution of approaches to personalized therapy and position of international experts.

Keywords:

platelet reactivity

percutaneous coronary intervention

genetic testing

acute coronary syndrome

bleeding events

antiplatelet therapy

coronary artery disease

thrombotic events

micro-RNA

Authors:

Khakimova M.B.

Chazov National Medical Research Center of Cardiology

Komarov A.L.

National Medical Research Center of Cardiology named after academician E.I. Chazov

Dobrovolskiy A.B.

Chazov National Medical Research Center of Cardiology

Panchenko E.P.

National Medical Research Center of Cardiology

Received:

26.09.2022

Accepted:

05.10.2022

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