Genotype Directed Antiplatelet Therapy, Is the Time Right?

Anti-platelet therapy has been a mainstay of therapeutics following percutaneous coronary intervention. Aspirin, typically 81 mg daily, in combination with another agent is most used. The most prescribed drug in addition to aspirin is clopidogrel. Clopidogrel is generally very well tolerated, however it is a prodrug, and must be enzymatically activated for therapeutic effect. The alternatives of ticagrelor and prasugrel also exist. Increasing evidence suggest that a precision medicine approach to anti-platelet therapy following PCI maximizes efficacy and safety and minimizes cost.