Genetic approach to the laboratory efficacy of anti-platelet treatment in patients after coronary stent implantation

Abstract

Coronary artery disease (CAD) is known to be a very heterogeneous disease of multifactorial origin affecting millions world-wide and being the top leading cause of death among the middle-aged population. The development of percutaneous coronary intervention (PCI) has revolutionized the treatment of ischaemic heart disease. However, despite the efforts some short and longer term complication has been realized; acute stent thrombosis (ST) and instent restenosis (ISR), both resulting in target-vessel failure after PCI, still occur. Significant interindividual differences in response to anti-platelet therapy have recently been recognized with supposed environmental, clinical, pharmacokinetic and genetic background. While lack of standardization in platelet function assays and paucity of well defined cut off values represent further difficulties of the subject. The circumstances that individuals may have different needs for anti-platelet action as well as different risk for bleeding, point toward the need for an individualized therapeutic regime.