Biomarkers for Antiplatelet Therapy

Antiplatelet therapies are largely used to prevent recurrent cardiovascular events in patients receiving percutaneous coronary intervention for stable coronary artery disease or in patients with acute coronary syndrome (ACS). P2Y12 inhibitors are the most commonly used drugs as antiplatelet regimen. Despite adequate therapy, some patients continue to have cardiovascular events such as ACS. Therefore biomarkers may be useful to identify patients who are at high risk for such events. Multiple factors can influence the variability of response to antiplatelet drugs. However, the pathway of P2Y12 blockade resulting in inhibition of platelet activation and aggregation has allowed the development of biomarkers to assess platelet function. The two main biomarkers that have shown benefit in risk prediction are phenotypic (platelet reactivity) and genotypic (testing for CYP2C19 alleles) biomarkers. Some studies suggest but do not establish that these biomarkers may have a role in guiding the choice of antiplatelet agent.