Genotype-guided antiplatelet therapy compared with conventional therapy for patients with acute coronary syndromes: a systematic review and meta-analysis.
Biomarkers
; 24(6): 517-523, 2019 Sep.
Article
en En
| MEDLINE
| ID: mdl-31215825
ABSTRACT
To evaluate whether genotype-guided antiplatelet therapy reduces the rates of cardiovascular events and bleeding events in patients with acute coronary syndrome (ACS). We systematically searched Pubmed, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL) (searched in September 2018) for controlled studies evaluating genotype-guided antiplatelet therapy in ACS with percutaneous coronary intervention (PCI) or without PCI. The primary endpoint was a composite of death, myocardial infarction (MI), stroke, targeted vessel revascularization and/or major bleeding. A total of five studies involving 2900 patients were included. Compared with the conventional group, the genotype-guided group had a decreased risk of primary composite outcomes (RR= 0.54; 95% CI 0.41-0.72; I2 = 30%), death (RR = 0.54; 95% CI 0.32-0.94; I2 = 21%), MI (RR = 0.52; 95% CI 0.31-0.88; I2 = 49%), targeted vessel revascularization (RR = 0.59; 95% CI 0.35-0.98; I2 = 0%), but not for stroke (RR = 0.53; 95% CI 0.22-1.24; I2 = 0%) and bleeding events (RR = 0.80; 95% CI 0.51-1.25; I2 = 33%). Genotype-guided strategies could reduce the rates of cardiovascular events without increasing bleeding events compared with conventional treatment in ACS. Future multi-centre genotype-based randomized control trials are required to confirm these findings.
Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Trombosis
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Inhibidores de Agregación Plaquetaria
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Accidente Cerebrovascular
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Síndrome Coronario Agudo
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Citocromo P-450 CYP2C19
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Hemorragia
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Infarto del Miocardio
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Biomarkers
Asunto de la revista:
BIOQUIMICA
Año:
2019
Tipo del documento:
Article
País de afiliación:
China