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Platelet Function Test Use for Patients with Coronary Artery Disease in the Early 2020s

1
Geneva Platelet Group, Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland
2
Division of Angiology and Haemostasis, Geneva University Hospitals, 1205 Geneva, Switzerland
3
Division of Cardiology, Geneva University Hospitals, 1205 Geneva, Switzerland
4
Division of General Internal Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(1), 194; https://doi.org/10.3390/jcm9010194
Received: 9 December 2019 / Revised: 2 January 2020 / Accepted: 7 January 2020 / Published: 10 January 2020
In the field of antithrombotics, precision medicine is of particular interest, as it may lower the incidence of potentially life-threatening side effects. Indeed, antiplatelet drugs such as P2Y12 inhibitors are one of the most common causes of emergency admissions for drug-related adverse events. The last ten years have seen a continuous debate on whether platelet function tests (PFTs) should be used to tailor antiplatelet drugs to cardiovascular patients. Large-scale randomized studies investigating the escalation of antiplatelet therapies according to the results of PFTs were mostly negative. Potent P2Y12 inhibitors are recommended as a first-line treatment in acute coronary syndrome patients, bringing the bleeding risk at the forefront. De-escalation from prasugrel or ticagrelor to clopidogrel is now considered, with or without the use of a PFT. This review covers recent advances in escalation and de-escalation strategies based on PFTs in various clinical settings. It also describes the main features of the most popular platelet function tests as well as the potential added value of genetic testing. Finally, we detail practical suggestions on how PFTs could be used in clinical practice. View Full-Text
Keywords: platelet function test; precision medicine; antiplatelet drug; cardiovascular patient; acute coronary syndrome platelet function test; precision medicine; antiplatelet drug; cardiovascular patient; acute coronary syndrome
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Fontana, P.; Roffi, M.; Reny, J.-L. Platelet Function Test Use for Patients with Coronary Artery Disease in the Early 2020s. J. Clin. Med. 2020, 9, 194.

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