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01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Cardiovascular Disorders 1/2017

Individualized dual antiplatelet therapy based on platelet function testing in patients undergoing percutaneous coronary intervention: a meta-analysis of randomized controlled trials

Zeitschrift:
BMC Cardiovascular Disorders > Ausgabe 1/2017
Autoren:
Yijiang Zhou, Yanwei Wang, Yutao Wu, Chaoyang Huang, Hui Yan, Weiguo Zhu, Weiwei Xu, Li Zhang, Jianhua Zhu
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12872-017-0582-6) contains supplementary material, which is available to authorized users.

Abstract

Background

High on-treatment platelet reactivity (HPR) represents a strong risk factor for thrombotic events after PCI. We aim to evaluate the efficacy and safety of individualizing intensified dual antiplatelet therapy (DAPT) in PCI-treated patients with HPR based on platelet function testing (PFT).

Methods

Electronic databases were searched for randomized control trials that reported the clinical outcomes of using an intensified antiplatelet protocol with P2Y12 receptor inhibitor comparing with standard maintenance dose of clopidogrel on the basis of platelet function testing. Clinical endpoints were assessed.

Results

From 2005 to 2016, thirteen clinical studies comprising 7290 patients were included for analysis. Compared with standard antiplatelet therapy with clopidogrel, the intensified protocol based on platelet function testing was associated with a significant reduction in major adverse cardiovascular events (RR:0.55, 95% CI: 0.36–0.84, p = 0.005), cardiovascular death (RR:0.60, 95% CI: 0.38–0.96, p = 0.03), stent thrombosis (RR:0.58, 95% CI: 0.36–0.93, p = 0.02) and target vessel revascularization (RR:0.33, 95% CI: 0.14–0.76, p = 0.009). No significant difference was found in the rate of bleeding events between intensified and standard protocol.

Conclusions

Compared with standard clopidogrel therapy, individualized intensified antiplatelet therapy on the basis of platelet reactivity testing reduces the incidence of cardiovascular events in patient undergoing PCI, without increasing the risk of bleeding.
Zusatzmaterial
Additional file 1: Supplemental Material. (DOC 365 kb)
12872_2017_582_MOESM1_ESM.doc
Literatur
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