AUTHOR=Ostrowska Małgorzata , Kubica Jacek , Adamski Piotr , Kubica Aldona , Eyileten Ceren , Postula Marek , Toma Aurel , Hengstenberg Christian , Siller-Matula Jolanta M. 

TITLE=Stratified Approaches to Antiplatelet Therapies Based on Platelet Reactivity Testing

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=6

YEAR=2019

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2019.00176

DOI=10.3389/fcvm.2019.00176

ISSN=2297-055X

ABSTRACT=<p>Antiplatelet therapy with P2Y<sub>12</sub> receptor inhibitors (clopidogrel, prasugrel, ticagrelor, cangrelor) is a cornerstone of medical therapy after percutaneous coronary interventions. Significant prevalence of high on-treatment platelet reactivity (HTPR) on clopidogrel treatment led to introduction of more potent P2Y<sub>12</sub> inhibitors: prasugrel (a third generation thienopyridine), ticagrelor, and cangrelor (cyclopentyl-triazolo-pyrimidines). Nevertheless, more potent platelet inhibition and resulting low on-treatment platelet reactivity (LTPR) has led to increased risk of major bleeding events. These limitations resulted in a need for an individualized antiplatelet therapy approach. This review discusses the current role and future perspectives of diagnostic tools such as platelet function testing to optimize antiplatelet therapy with a focus on deescalating therapies to reduce bleeding risks.</p>