Guiding Antiplatelet Therapy: Is a Personalized Approach Worth It?

Authors:
Kiana R. Green, PharmD
Augustus (Rob) Hough, PharmD, BCPS (AQ Cardiology), BCCP

Reviewers:
Katelyn Callaghan, PharmD
Alina Kukin, PharmD, BCCP
Sarah Anderson, PharmD, BCPS, BCACP

Citation: Galli M, Benenati S, Copadanno D, et al. Guided versus standard antiplatelet therapy in patients undergoing percutaneous coronary interventions: a systemic review and meta-analysis.  Lancet 2021;397:1470-83

The Problem

The variability in clopidogrel pharmacokinetics among patients resulting in inconsistent effects on platelet inhibition and leading to poor outcomes has been appreciated for years.¹  Multiple strategies to personalize antiplatelet therapy intended to balance the risks and benefits of therapy have been tested. However, there is no consensus on which strategy, if any, is ideal or if attempting to personalize P2Y12 inhibitor therapy is beneficial to patients or health care systems.²