A personalized approach to current antiplatelet therapy strategies

Antiplatelet therapy, which consists primarily of aspirin (acetylsalicylic acid) and P2Y₁₂ receptor antagonists, is one of the most commonly prescribed treatments in current clinical practice, because of the steadily increasing incidence of cardiovascular disease and the related high mortality rates. Antiplatelet agents are valuable tools for physicians because they can prevent atherothrombotic events, improve clinical outcomes, and reduce cardiovascular mortality rates in primary and secondary prevention. However, secondary bleeding remains a concern with antiplatelet therapy. The current goal of medical science is to minimize bleeding risk in patients at high risk for hemorrhagic events. This review presents data on antiplatelet drugs used in real-world clinical practice. It provides detailed, comprehensive descriptions of their use in various situations and highlights strategies for switching between them. The review also discusses the consequences of high residual platelet reactivity after treatment and summarizes current trends in patient-centered medicine. Additionally, the work revealed the high potential for developing effective and safe agents to counteract the effects of antiplatelet agents. New antiplatelet agents are being developed, such as selatogrel, revacept, and glenzocimab. Further research is required to understand how these potential new agents will integrate into the current antiplatelet therapy paradigm and whether they will promote safer clinical practices. Although significant advances in optimizing antiplatelet therapy have been made through clinical studies, more work is yet to be done. Most genetic intervention studies focus on CYP2C19 polymorphisms in order to personalize antiplatelet treatment strategies.