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Open research questions in Antiplatelet Therapy and Cardiovascular Diseases

275 gap statements mined from Antiplatelet Therapy and Cardiovascular Diseases papers in our 7.9M-paper local library, which holds 1,542 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

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What the literature leaves open

  • Availability of resources needed to successfully obtain laboratory samples, including absence of standardized procedural guidelines and inconsistent equipment availability.

    Testing for Aspirin Resistance in Pediatric Patients with Single Ventricle and Ductal Stented Cardiac Disease: A Single Center Quality Improvement Initiative · 2026 · DOI

  • The lack of established methods for determining aspirin resistance in pediatric patients. The need for improved rates of platelet function testing in this population.

    Testing for Aspirin Resistance in Pediatric Patients with Single Ventricle and Ductal Stented Cardiac Disease: A Single Center Quality Improvement Initiative · 2026 · DOI

  • The balance between ischemic protection and bleeding avoidance is particularly difficult in patients at high bleeding risk. The optimal maintenance antiplatelet strategy after DAPT discontinuation remains uncertain. The network meta-analysis was limited by the small number of studies and the sparse network.

    Antiplatelet monotherapy maintenance strategies after percutaneous coronary intervention in patients with coronary artery disease at high bleeding risk: a network meta-analysis · 2026 · DOI

  • The exact mechanism of ticagrelor-induced bradyarrhythmias is unclear. There is a need for awareness of these adverse effects, particularly during the early post-ACS phase. The paper aims to contribute to the understanding of ticagrelor-induced bradyarrhythmias and conduction complications in ACS patients.

    Unveiling the Hidden Risk: Ticagrelor-Induced Bradyarrhythmias and Conduction Complications in ACS Patients—Case Series · 2025 · DOI

  • The effectiveness of antiplatelet agents in ischemic stroke patients with acute kidney injury is unclear. There is a need to explore the impact of acute kidney injury staging on antiplatelet therapy in ischemic stroke patients. The study aims to address this research gap by investigating the mortality risk of combination antiplatelet therapy in patients with ischemic stroke and acute kidney injury.

    Mortality Risk Analysis of Combination Antiplatelet Therapy in Patients with Ischemic Stroke and Acute Kidney Injury: A Retrospective Cohort Analysis of the MIMIC-IV Database · 2025 · DOI

  • The study highlights the need to explore the association between elevated RPR and clinical-metabolic features in patients with recurrent ischemia after CABG. The gap is not explicitly stated, but it appears to be the lack of knowledge on the relationship between RPR and dyslipidemia in post-CABG patients.

    Residual Platelet Reactivity and Dyslipidemia in Post-CABG Patients Undergoing Repeat Revascularization: Insights from Kazakhstan · 2025 · DOI

  • Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is associated with substantial ischemic risk, yet the optimal duration of dual antiplatelet therapy (DAPT) after successful CTO-PCI remains uncertain.

    Extended Versus Short Dual Antiplatelet Therapy Duration After Percutaneous Coronary Intervention for Chronic Total Occlusion · 2026 · DOI

  • These findings suggest that a bleeding-focused long-term antithrombotic strategy may be reasonable in patients with atrial fibrillation and chronic coronary syndrome, including those with prior complex PCI, although prospective validation remains warranted.

    Antithrombotic Therapy in Patients With Atrial Fibrillation With Prior Complex PCI: A Secondary Analysis of the Randomized ADAPT AF-DES Trial · 2026 · DOI

  • In patients with atrial fibrillation and chronic coronary syndrome beyond 12 months after percutaneous coronary intervention (PCI), oral anticoagulant monotherapy is recommended by the guideline; however, its efficacy and safety in patients with complex PCI remain uncertain.

    Antithrombotic Therapy in Patients With Atrial Fibrillation With Prior Complex PCI: A Secondary Analysis of the Randomized ADAPT AF-DES Trial · 2026 · DOI

  • However, whether treatment effects differ according to overall atherothrombotic risk integrating clinical and angiographic factors remains unclear.

    Clopidogrel Versus Aspirin Monotherapy According to Atherothrombotic Risk Profile · 2026 · DOI

  • However, the comparative effectiveness of clopidogrel versus aspirin in populations with lower levels of clopidogrel resistance remains to be further investigated.

    Clopidogrel monotherapy is associated with higher mortality risk compared to aspirin: a retrospective analysis of NHANES 1999–2018 · 2025 · DOI

  • Urinary 11-dehydro-TXB2, a biomarker indicative of platelet activation, has been associated with thrombotic events, but its association with bleeding events remains unexplored.

    Association of thromboxane generation with the bleeding events in aspirin users · 2025 · DOI

  • Optimal long term antithrombotic treatment in high-risk chronic coronary syndrome (CCS) patients remains uncertain.

    Differential effects of dual antiplatelet and dual antithrombotic therapy on hemostasis in chronic coronary syndrome patients: the DEFINE CCS study · 2025 · DOI

  • Further studies of a larger scale are indeed needed to apply this information to pursue individualized treatment.

    Prevalence of Aspirin or Clopidogrel Pharmacological Resistance in Ischemic Stroke: A Step Toward Precision Medicine · 2025 · DOI

  • The optimal duration of dual antiplatelet therapy (DAPT) after complex percutaneous coronary intervention (PCI) remains unclear.

    Short-Term DAPT After Complex PCI With Third-Generation DES: A Post Hoc Analysis of the HOST-IDEA Trial · 2025 · DOI

  • However, recent studies reported a paradoxical phenomenon that PCI patients with TP were prone to experience thrombotic events, while the mechanisms and future treatment remain unclear.

    Inflammation modifies the platelet reactivity among thrombocytopenia patients undergoing percutaneous coronary intervention · 2024 · DOI

  • Our findings suggest new targets (both at the gene and pathway levels) that may increase susceptibility to MACEs, but further research is needed to clarify the role and impact of the identified variants before these findings can be incorporated into the therapeutic decision-making process.

    Targeted next-generation sequencing panel to investigate antiplatelet adverse reactions in acute coronary syndrome patients undergoing percutaneous coronary intervention with stenting · 2024 · DOI

  • The association of aspirin loading with the risk of coronary no‐reflow (CNR) after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) has not been investigated.

    Aspirin loading and coronary no‐reflow after percutaneous coronary intervention in patients with acute myocardial infarction · 2024 · DOI

  • Despite medical guidelines recommending minimal dual antiplatelet therapy (DAPT) duration for patients with cancer, dedicated data on abbreviated DAPT in this population is lacking.

    Risk Burden of Cancer in Patients Treated With Abbreviated Dual Antiplatelet Therapy After PCI: Analysis of Multicenter Controlled High-Bleeding Risk Trials · 2024 · DOI

  • Current guidelines and risk stratification tools have limitations. There is a need for a more integrated approach to managing antithrombotic therapy.

    Toward an integrated risk paradigm: personalizing antithrombotic therapy for coronary heart disease with gastrointestinal bleeding · 2026 · DOI

  • Advancing the proposed approach will depend on collaborative efforts across academic, clinical, and healthcare-administrative domains. Priorities should include the development of integrated risk-assessment tools and prospective research focused on personalized treatment strategies.

    Toward an integrated risk paradigm: personalizing antithrombotic therapy for coronary heart disease with gastrointestinal bleeding · 2026 · DOI

  • Indication bias may be present, given that patients in the AP group had higher prevalences of coronary artery disease and other high-risk features. The study has a relatively small sample size. The role of antiplatelet therapy in primary prevention among at-risk populations remains poorly defined.

    A Retrospective Study of 518 Kidney Transplant Recipients to Evaluate the Association of Antiplatelet Therapy With Long-Term Cardiovascular Events and All-Cause Mortality · 2026 · DOI

  • The role of antiplatelet therapy in primary prevention among at-risk populations remains poorly defined. There is a need for further research to fully understand the association of antiplatelet therapy with long-term cardiovascular events and all-cause mortality in kidney transplant recipients.

    A Retrospective Study of 518 Kidney Transplant Recipients to Evaluate the Association of Antiplatelet Therapy With Long-Term Cardiovascular Events and All-Cause Mortality · 2026 · DOI

  • The network was connected but sparse and did not contain closed loops. The absence of closed loops precluded formal inconsistency testing. Between-study heterogeneity was estimated in the random-effects model, but the small number of studies limited the precision of heterogeneity estimation. The sparse network and low certainty of evidence limited the conclusions.

    Antiplatelet monotherapy maintenance strategies after percutaneous coronary intervention in patients with coronary artery disease at high bleeding risk: a network meta-analysis · 2026 · DOI

  • Postendoscopic submucosal dissection (ESD) bleeding remains a critical concern in patients receiving antithrombotic therapy, yet the risk after esophageal ESD is poorly characterized.

    Risk of Postoperative Bleeding in Esophageal Endoscopic Submucosal Dissection for Squamous Cell Carcinoma in Patients on Antiplatelet Therapy: A Multicenter Retrospective Study in Japan · 2026 · DOI

Most-cited papers in Antiplatelet Therapy and Cardiovascular Diseases

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Open questions raised by papers listed on this page include: (1) The lack of established methods for determining aspirin resistance in pediatric patients (“Testing for Aspirin Resistance in Pediatric Patients with Single Ventricle and…”, 2026); (2) Whether treatment effects differ according to overall atherothrombotic risk integrating clinical and angiographic factors remains unclear (“Clopidogrel Versus Aspirin Monotherapy According to Atherothrombotic Risk…”, 2026); (3) There is a need for a more integrated approach to managing antithrombotic therapy (“Toward an integrated risk paradigm: personalizing antithrombotic therapy for…”, 2026); (4) There is a need for further research to fully understand the association of antiplatelet therapy with long-term cardiovascular events and all-cause mortality in kidney transplant recipients (“A Retrospective Study of 518 Kidney Transplant Recipients to Evaluate the…”, 2026); (5) The exact mechanism of ticagrelor-induced bradyarrhythmias is unclear (“Unveiling the Hidden Risk: Ticagrelor-Induced Bradyarrhythmias and Conduction…”, 2025). 275 gap statements have been mined from Antiplatelet Therapy and Cardiovascular Diseases papers in our 7.9M-paper local library, which holds 1,542 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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