Is There a Role for Platelet Function Testing for Patients on Chronic Dual Antiplatelet Therapy?

Antiplatelet therapy is one on the cornerstones in managing patients with coronary artery disease who have undergone percutaneous interventions. Aspirin plus a thienopyridine (ticlopidine, clopidogrel, prasugrel) are the components of dual antiplatelet therapy (DAPT). Clopidogrel remains the primary thienopyridine in use. There is a significant amount of heterogeneity in patients' response to the drug, both pharmacologically and clinically. It is apparent that those with high residual platelet reactivity on therapy are at an increased risk for future cardiovascular events. Therefore, platelet function testing makes sense and should be done routinely in patients on DAPT. These data provide physicians with an ability to adjust or change the antiplatelet therapy in response to the residual platelet reactivity. Options include increasing the dose of the present drug or changing to an alternative. The recent evidence regarding these data is reviewed in this article.