Mechanisms and Recent Advances in Non-coding RNAs and RNA Modifications in Antiplatelet Drug Resistance

Ping Ni^1,2Kejie Chen³Jing Xiang²Haifeng Shao⁴Xiaoling Chen⁵Qiao Chen⁴Lingling Wang⁶Junli Hao⁷yi xin Huang⁷Qing Cao⁵li ya Yang⁴Quandan Tan^8*Jie Yang^2*ping Su Li^2*

• ¹School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
• ²Department of Neurology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
• ³Department of Public Health, Chengdu Medical College, Chengdu, Sichuan Province, China
• ⁴School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
• ⁵Department of Clinical Medicine, Southwest Medical University, Luzhou, Sichuan Province, China
• ⁶College of Health Management, Xihua University, Chengdu, Sichuan Province, China
• ⁷School of Bioscience and Technology, Chengdu Medical College, Chengdu, Sichuan Province, China
• ⁸Department of Neurology, First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan Province, China

The high incidence and mortality rates of cardiovascular and cerebrovascular diseases make them a significant global health challenge. Antiplatelet drugs play a central role in the prevention and treatment of these diseases. Despite the wide range of available antiplatelet drugs, antiplatelet drug resistance is not rare. So optimizing drug use through personalized treatment strategies to achieve maximum therapeutic benefit remains a major challenge in clinical practice. Non-coding RNAs, including microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs), have made significant progress in understanding their regulatory roles in drug resistance, becoming a frontier area of current research. In addition to the regulatory functions of non-coding RNAs, emerging studies have highlighted the role of RNA modifications, such as N6-methyladenosine (m6A), in the regulation of gene expression and cellular processes involved in antiplatelet drug resistance. These modifications contribute to the stability, splicing, and translation of RNA, further influencing their roles in drug resistance mechanisms. In recent years, significant progress has been made in the research of non-coding RNAs and RNA modifications, revealing their crucial roles in the mechanisms of antiplatelet drug resistance. This review focuses on the latest advancements in non-coding RNA research related to antiplatelet drug resistance and explores the emerging field of RNA modifications. It analyzes potential underlying mechanisms and discusses future research directions, aiming to provide new theoretical support and research perspectives for personalized precision antiplatelet (Summary Picture).