ABSTRACT
Antiplatelet therapy represents the cornerstone of treatment for
the short-and long-term prevention of atherothrombotic disease
processes, particularly in high-risk settings such as patients with
acute coronary syndrome and those undergoing percutaneous coro-
nary intervention. Unfortunately, a considerable number of patients
still experience adverse outcomes even when treated with recom-
mended standard-of-care antiplatelet treatment regimens consist-
ing of aspirin and clopidogrel. The broad interindividual response
variability to antiplatelet therapy may explain, in part, adverse out-
comes in patients treated with antiplatelet medications. Genotypes
and phenotypes can contribute to individuals’ response profiles. The
aim of this chapter is to provide definitions of antiplatelet drug
response variability and describe the underlying mechanisms with
emphasis on recent understandings on pharmacogenetics and how
this may be considered for guiding antiplatelet therapy.
