Genotype-Guided Use of P2Y12 Inhibitors: A Review of Current State of the Art
The pharmacodynamics of the purinergic receptor type Y, subtype 12 (P2Y12) inhibitors has evolved. Our understanding of the metabolism of P2Y12 inhibitors has revealed polymorphisms that impact drug metabolism and antiplatelet efficacy, leading to genetic testing guided therapy. In addition, assays...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.850028/full |
| _version_ | 1811311823962505216 |
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| author | Abdullah Al-abcha Yasser Radwan Danielle Blais Ernest L. Mazzaferri Konstantinos Dean Boudoulas Essa M. Essa Richard J. Gumina |
| author_facet | Abdullah Al-abcha Yasser Radwan Danielle Blais Ernest L. Mazzaferri Konstantinos Dean Boudoulas Essa M. Essa Richard J. Gumina |
| author_sort | Abdullah Al-abcha |
| collection | DOAJ |
| description | The pharmacodynamics of the purinergic receptor type Y, subtype 12 (P2Y12) inhibitors has evolved. Our understanding of the metabolism of P2Y12 inhibitors has revealed polymorphisms that impact drug metabolism and antiplatelet efficacy, leading to genetic testing guided therapy. In addition, assays of platelet function and biochemistry have provided insight into our understanding of the efficacy of “antiplatelet” therapy, identifying patients with high or low platelet reactivity on P2Y12 therapy. Despite the data, the implementation of these testing modalities has not gained mainstream adoption across hospital systems. Given differences in potency between the three clinically available P2Y12 inhibitors, the balance between thrombotic and bleeding complications must be carefully considered, especially for the large proportion of patients at higher risk for bleeding. Here we review the current data for genetic and functional testing, risk assessment strategies, and guidelines for P2Y12 inhibitors guided therapy. |
| first_indexed | 2024-04-13T10:24:35Z |
| format | Article |
| id | doaj.art-f25b8c877712472d9345cdf63c9b3567 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-13T10:24:35Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-f25b8c877712472d9345cdf63c9b35672022-12-22T02:50:21ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-03-01910.3389/fcvm.2022.850028850028Genotype-Guided Use of P2Y12 Inhibitors: A Review of Current State of the ArtAbdullah Al-abcha0Yasser Radwan1Danielle Blais2Ernest L. Mazzaferri3Konstantinos Dean Boudoulas4Essa M. Essa5Richard J. Gumina6Division of Internal Medicine, Department of Medicine, Michigan State University, East Lansing, MI, United StatesDivision of Internal Medicine, Department of Medicine, Michigan State University, East Lansing, MI, United StatesDivision of Cardiology, Department of Medicine, Ohio State University, Columbus, OH, United StatesDivision of Cardiology, Department of Medicine, Ohio State University, Columbus, OH, United StatesDivision of Cardiology, Department of Medicine, Ohio State University, Columbus, OH, United StatesDivision of Cardiology, Department of Medicine, Mount Carmel Healthcare, Columbus, OH, United StatesDivision of Cardiology, Department of Medicine, Ohio State University, Columbus, OH, United StatesThe pharmacodynamics of the purinergic receptor type Y, subtype 12 (P2Y12) inhibitors has evolved. Our understanding of the metabolism of P2Y12 inhibitors has revealed polymorphisms that impact drug metabolism and antiplatelet efficacy, leading to genetic testing guided therapy. In addition, assays of platelet function and biochemistry have provided insight into our understanding of the efficacy of “antiplatelet” therapy, identifying patients with high or low platelet reactivity on P2Y12 therapy. Despite the data, the implementation of these testing modalities has not gained mainstream adoption across hospital systems. Given differences in potency between the three clinically available P2Y12 inhibitors, the balance between thrombotic and bleeding complications must be carefully considered, especially for the large proportion of patients at higher risk for bleeding. Here we review the current data for genetic and functional testing, risk assessment strategies, and guidelines for P2Y12 inhibitors guided therapy.https://www.frontiersin.org/articles/10.3389/fcvm.2022.850028/fullgenotypeP2Y12guided therapyplateletfunction |
| spellingShingle | Abdullah Al-abcha Yasser Radwan Danielle Blais Ernest L. Mazzaferri Konstantinos Dean Boudoulas Essa M. Essa Richard J. Gumina Genotype-Guided Use of P2Y12 Inhibitors: A Review of Current State of the Art Frontiers in Cardiovascular Medicine genotype P2Y12 guided therapy platelet function |
| title | Genotype-Guided Use of P2Y12 Inhibitors: A Review of Current State of the Art |
| title_full | Genotype-Guided Use of P2Y12 Inhibitors: A Review of Current State of the Art |
| title_fullStr | Genotype-Guided Use of P2Y12 Inhibitors: A Review of Current State of the Art |
| title_full_unstemmed | Genotype-Guided Use of P2Y12 Inhibitors: A Review of Current State of the Art |
| title_short | Genotype-Guided Use of P2Y12 Inhibitors: A Review of Current State of the Art |
| title_sort | genotype guided use of p2y12 inhibitors a review of current state of the art |
| topic | genotype P2Y12 guided therapy platelet function |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.850028/full |
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