Individualized dual antiplatelet therapy based on platelet function testing in patients undergoing percutaneous coronary intervention: a meta-analysis of randomized controlled trials.
BMC Cardiovasc Disord
; 17(1): 157, 2017 06 15.
Article
em En
| MEDLINE
| ID: mdl-28619104
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 (RR0.55, 95% CI 0.36-0.84, p = 0.005), cardiovascular death (RR0.60, 95% CI 0.38-0.96, p = 0.03), stent thrombosis (RR0.58, 95% CI 0.36-0.93, p = 0.02) and target vessel revascularization (RR0.33, 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.Palavras-chave
Texto completo:
1
Eixos temáticos:
Pesquisa_clinica
Base de dados:
MEDLINE
Assunto principal:
Testes de Função Plaquetária
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Plaquetas
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Trombose Coronária
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Ticlopidina
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Inibidores da Agregação Plaquetária
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Agregação Plaquetária
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Síndrome Coronariana Aguda
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Medicina de Precisão
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Receptores Purinérgicos P2Y12
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Antagonistas do Receptor Purinérgico P2Y
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
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Guideline
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Prognostic_studies
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Systematic_reviews
Limite:
Humans
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article