Platelet Function Monitors

According to a new study, genetic profiling of patients undergoing percutaneous coronary intervention (PCI) may help cardiology teams adjust treatment and improve ischemic outcomes for patients who do not properly metabolize thienopyridine blood thinning therapies such as clopidogrel.

The year 2013 has brought us several important clinical trials that have changed the way interventional cardiologists approach and treat patients with stable coronary artery disease. These trials were a major focus at the “Hottest Topics 2013” session at the Society for Cardiovascular Angiography and Interventions (SCAI) 2013 Scientific Sessions

Patients with 2C19 that is less active due to loss of gene copies are poor metabolizers of clopidogrel, opening patients to the possibility of a higher rate of mayocardial infacrtion (MI). There are assays for platelet function response (VerifyNow) and genetic tests to measure patient response, which could help determine if generic clopdogrel or more expensive agents should be used.

The standard-of-care for dual antiplatelet therapy (DAPT) for more than a decade has been clopidogrel (Plavix) plus aspirin. This standard is now being challenged by new agents — ticagrelor (Brilinta) and prasugrel (Effient). While the new agents are more effective at preventing platelet aggregation than clopidogrel, each has unique characteristics. Plavix went generic earlier this year, which may also impact decisions about which therapies to use.