Updated Expert Consensus Statement on Platelet Function and Genetic Testing for Guiding P2Y12 Receptor Inhibitor Treatment in Percutaneous Coronary Intervention
2019
Sibbing, Dirk | Aradi, Daniel | Alexopoulos, Dimitrios | ten Berg, Jurriën | Bhatt, Deepak | Bonello, Laurent | Collet, Jean-Philippe | Cuisset, Thomas | Franchi, Francesco | Gross, Lisa | Gurbel, Paul | Jeong, Young-Hoon | Mehran, Roxana | Moliterno, David | Neumann, Franz-Josef | Pereira, Naveen | Price, Matthew | Sabatine, Marc, S | So, Derek Y.F. | Stone, Gregg | Storey, Robert | Tantry, Udaya | Trenk, Dietmar | Valgimigli, Marco | Waksman, Ron | Angiolillo, Dominick | Ludwig Maximilian University [Munich] = Ludwig Maximilians Universität München (LMU) | Semmelweis University [Budapest] | University of Athens Medical School [Athens] | St. Antonius Hospital [Nieuwegein] | VA Boston Healthcare System | Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN) ; Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) | Institut de cardiologie [CHU Pitié-Salpêtrière] ; CHU Pitié-Salpêtrière [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU) | University of North Florida [Jacksonville] (UNF) | Gyeongsang National University | Icahn School of Medicine at Mount Sinai [New York] (MSSM) | University of Kentucky (UK) | University Hospital Freiburg | Mayo Clinic | Scripps Clinic [San Diego, CA, USA] | Harvard Medical School [Boston] (HMS) | University of Ottawa [Ottawa] | Columbia University [New York] | University of Sheffield [Sheffield] | Mount Sinai Hospital [Toronto, Canada] (MSH) | Universität Bern = University of Bern = Université de Berne (UNIBE) | Washington University School of Medicine in St. Louis ; Washington University in Saint Louis (WUSTL) | University of Florida [Gainesville] (UF)
International audience
Show more [+] Less [-]English. Dual-antiplatelet therapy (DAPT) with aspirin and a P2Y(12) receptor inhibitor is the standard treatment for patients undergoing percutaneous coronary intervention. The availability of different P2Y(12) receptor inhibitors (clopidogrel, prasugrel, ticagrelor) with varying levels of potency has enabled physicians to contemplate individualized treatment regimens, which may include escalation or de-escalation of P2Y(12)-inhibiting therapy. Indeed, individualized and alternative DAPT strategies may be chosen according to the clinical setting (stable coronary artery disease vs. acute coronary syndrome), the stage of the disease (early-vs. long-term treatment), and patient risk for ischemic and bleeding complications. A tailored DAPT approach may be potentially guided by platelet function testing (PFT) or genetic testing. Although the routine use of PFT or genetic testing in percutaneous coronary intervention-treated patients is not recommended, recent data have led to an update in guideline recommendations that allow considering selective use of PFT for DAPT de-escalation. However, guidelines do not expand on when to implement the selective use of such assays into decision making for personalized treatment approaches. Therefore, an international expert consensus group of key leaders from North America, Asia, and Europe with expertise in the field of antiplatelet treatment was convened. This document updates 2 prior consensus papers on this topic and summarizes the contemporary updated expert consensus recommendations for the selective use of PFT or genotyping in patients undergoing percutaneous coronary intervention. (c) 2019 by the American College of Cardiology Foundation.
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