Platelet reactivity and percutaneous coronary intervention: another clue in the quest for the Holy Grail of tailored antithrombotic therapy?

A large investigational effort has been made over the past 30 years in the attempt to identify the optimal antithrombotic therapy for patients undergoing percutaneous coronary intervention (PCI). One of the key messages consistently arising from clinical trials is that the stronger the platelet inhibition at the time of PCI, the lower the incidence of thrombotic events following the procedure (1–4). The periprocedural period is a vulnerable time frame during which the patient’s prognosis is mainly delineated. An adequate pre-PCI antiplatelet treatment is required not only to prevent thrombotic complications immediately after the procedure, but also to reduce recurrent ischemic events at follow-up. This is particularly true for patients with acute