Background: Pharmacogenetics investigates the response to pharmacological
treatments based on individual genetic background. Actually, numerous pharmacogenetic
tests help to predict the response to drugs used in different medical areas, contributing to
the so-called personalized medicine.
Objective: This review aims to update the available data on the genotype-guided treatment
with both the anticoagulant and antiplatelet agents. Moreover, it sheds light on the
pitfalls in the implementation of cardiovascular pharmacogenetics.
Methods: A review of the literature on the studies investigating the effects of the genotype-
guided anticoagulant and antiplatelet treatment was performed.
Results: Considering the extensive use of antithrombotic drugs, pharmacogenetics has
particular importance in this field. Several polymorphisms influence the response to both
anticoagulant and antiplatelet agents, and tests, based on their identification, are now
Conclusion: Recent randomized clinical trials demonstrated that pharmacogenetics
might successfully contribute to optimizing the antiplatelet therapy also in patients particularly
complicated to treat. However, despite accumulating evidence on the utility and
feasibility of some pharmacogenetics tests, several barriers still exist in their implementation
in clinical practice.