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A Case of Pulmonary Hypertension Associated with Idiopathic Hypereosinophilic Syndrome The right ventricle in pulmonary hypertension Physiologic Characteristics and Clinical Outcomes of Patients With Discordance Between FFR and iFR Pulmonary arterial hypertension in congenital heart disease: an epidemiologic perspective from a Dutch registry The Relation Between Optical Coherence Tomography-Detected Layered Pattern and Acute Side Branch Occlusion After Provisional Stenting of Coronary Bifurcation Lesions Validation of bifurcation DEFINITION criteria and comparison of stenting strategies in true left main bifurcation lesions Predictors of Left Main Coronary Artery Disease in the ISCHEMIA Trial Real-world clinical utility and impact on clinical decision-making of coronary computed tomography angiography-derived fractional flow reserve: lessons from the ADVANCE Registry Pulmonary Artery Denervation: An Alternative Therapy for Pulmonary Hypertension Intravascular optical coherence tomography

Original ResearchJune 2019

JOURNAL:JACC: Cardiovascular Interventions Article Link

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

D Sibbing, D Aradi, D Alexopoulos et al. Keywords: genotyping; P2Y12 receptor inhibitor; platelet function testing; thrombosis

ABSTRACT


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 deescalation 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 deescalation. 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.