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Updated Expert Consensus Statement on Platelet Function and Genetic Testing for Guiding P2Y12 Receptor Inhibitor Treatment in Percutaneous Coronary Intervention.
Journal article

Updated Expert Consensus Statement on Platelet Function and Genetic Testing for Guiding P2Y12 Receptor Inhibitor Treatment in Percutaneous Coronary Intervention.

  • Sibbing D Department of Cardiology, LMU München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. Electronic address: dirk.sibbing@med.uni-muenchen.de.
  • Aradi D Heart Centre Balatonfüred and Heart and Vascular Centre, Semmelweis University, Budapest, Hungary.
  • Alexopoulos D 2nd Department of Cardiology, Attikon University Hospital, National and Capodistrian University of Athens, Athens, Greece.
  • Ten Berg J St. Antonius Center for Platelet Function Research, Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands.
  • Bhatt DL Brigham and Women's Heart and Vascular Institute, Harvard Medical School, Boston, Massachusetts.
  • Bonello L Department of Cardiology, Hopital Nord, AP-HM, Aix-Marseille University, Marseille, France.
  • Collet JP ACTION Study Group, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, Sorbonne Universite, Paris, France.
  • Cuisset T Department of Cardiology, CHU Timone, and Aix-Marseille Université, Faculté de Médecine, Marseille, France.
  • Franchi F Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida.
  • Gross L Department of Cardiology, LMU München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
  • Gurbel P Interventional Cardiology and Cardiovascular Medicine Research, Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Falls Church, Virginia.
  • Jeong YH Department of Internal Medicine, Gyeongsang National University School of Medicine and Cardiovascular Center, Gyeongsang National University Changwon Hospital, Changwon, Korea.
  • Mehran R Clinical Trials Center, Cardiovascular Research Foundation, New York, New York; Icahn School of Medicine at Mount Sinai, New York, New York.
  • Moliterno DJ Gill Heart Institute and Division of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky.
  • Neumann FJ Department of Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany.
  • Pereira NL Department of Cardiovascular Diseases, Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota.
  • Price MJ Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, California.
  • Sabatine MS TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
  • So DYF Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
  • Stone GW Center for Interventional Vascular Therapy, NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, New York; Cardiovascular Research Foundation, New York, New York.
  • Storey RF Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom.
  • Tantry U Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, Maryland.
  • Trenk D Department of Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany.
  • Valgimigli M Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland.
  • Waksman R Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
  • Angiolillo DJ Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida. Electronic address: dominick.angiolillo@jax.ufl.edu.
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  • 2019-06-17
Published in:
  • JACC. Cardiovascular interventions. - 2019
P2Y(12) receptor inhibitor
genotyping
platelet function testing
thrombosis
Blood Platelets
Clinical Decision-Making
Consensus
Coronary Thrombosis
Cytochrome P-450 CYP2C9
Dual Anti-Platelet Therapy
Hemorrhage
Humans
Patient Selection
Percutaneous Coronary Intervention
Pharmacogenomic Testing
Pharmacogenomic Variants
Platelet Aggregation Inhibitors
Platelet Function Tests
Precision Medicine
Predictive Value of Tests
Purinergic P2Y Receptor Antagonists
Receptors, Purinergic P2Y12
Risk Factors
Treatment Outcome
English Dual-antiplatelet therapy (DAPT) with aspirin and a P2Y12 receptor inhibitor is the standard treatment for patients undergoing percutaneous coronary intervention. The availability of different P2Y12 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 P2Y12-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.
Language
  • English
Open access status
bronze
Identifiers
Persistent URL
https://folia.unifr.ch/global/documents/111179
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