Personalisation of antiplatelet therapy and secondary prevention of ischemic stroke.

Abstract

The purpose of this systematic literature review is to highlight the current approach to the issue of “resistance” to antiplatelet drugs, presentation of a personalized approach to antiplatelet therapy in the treatment and secondary prevention of ischemic stroke, taking into account new foreign and Russian recommendations and research results. To achieve this goal, a systematic search was carried out with subsequent analysis of literary data and online resources. All reviews were indexed in PubMed, Medline, elibrary, CyberLeninka, Google Scholar databases. The article presents the main characteristics of the methods of laboratory evaluation of residual platelet reactivity used in clinical practice. It is shown that one of the rational approaches to improving the effectiveness and safety of antiplatelet therapy is to test the sensitivity ofpatients to the antiplatelet action of drugs (aggregatometry). In turn, pharmacogenetic testing makes it possible to predict the pharmacological response to the drug and is one of the promising prognostic tests that allow to assess the characteristics of individual sensitivity to the appointment of drug therapy. Particular emphasis in this review of the literature is made on a comprehensive approach, including the use ofpharmacogenetic and functional studies, the results and prospects of the results and prospects ofpharmacogenetic testing in the personalization of antiplatelet therapy of ischemic stroke in order to achieve the effectiveness of the greatest effect of antiplatelet drugs and reduce the risk of adverse reactions. This approach is important because it allows you to correct antiplatelet therapy in the treatment and secondary prevention of ischemic stroke in a timely manner, which makes it possible to develop an algorithm to achieve the effectiveness of antiplatelet therapy, choose an individual dose of the drug and the treatment regimen.