Document: Dual-antiplatelet therapy (DAPT) with aspirin and a P2Y12 receptor inhibitor is the standard treatment for patients undergoing percutaneous coronary
intervention. The availability of different P2Y12 receptor inhibitors (clopidogrel, prasugrel, ticagrelor) with varying levels of potency has enabled
physicians to contemplate individualized treatment regimens, which may include escalation or de-escalation of P2Y12-inhibiting therapy. Indeed,
individualized and alternative DAPT strategies may be chosen according to the clinical setting (stable coronary artery disease vs. acute coronary
syndrome), the stage of the disease (early- vs. long-term treatment), and patient risk for ischemic and bleeding complications. A tailored DAPT
approach may be potentially guided by platelet function testing (PFT) or genetic testing. Although the routine use of PFT or genetic testing in
percutaneous coronary intervention-treated patients is not recommended, recent data have led to an update in guideline recommendations that allow
considering selective use of PFT for DAPT de-escalation. However, guidelines do not expand on when to implement the selective use of such assays into
decision making for personalized treatment approaches. Therefore, an international expert consensus group of key leaders from North America, Asia, and
Europe with expertise in the field of antiplatelet treatment was convened. This document updates 2 prior consensus papers on this topic and summarizes
the contemporary updated expert consensus recommend