RT Journal Article
SR Electronic
T1 Tailored antiplatelet therapy and clinical adverse outcomes
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 41
OP 46
DO 10.1136/heartjnl-2013-304461
VO 100
IS 1
A1 Li, Jiabei
A1 Jian, Zhao
A1 Song, Mingbao
A1 Guo, Wenyun
A1 Chen, Guozhu
A1 Lu, 
Wei
A1 Qian, Dehui
A1 Ouyang, Jing'e
A1 Yu, Jie
A1 Hu, Houyuan
A1 Jin, Jun
A1 Wu, Xiaojing
A1 Huang, Lan
YR 2014
UL http://heart.bmj.com/content/100/1/41.abstract
AB Objective The clinical evidence regarding the influence of tailored antiplatelet strategy on adverse outcomes has been controversial. The aim of the study was to evaluate the significance of tailored antiplatelet therapy with respect to clinical adverse events in antiplatelet-resistant patients. Methods Randomised studies that assess clinical relevance of personalised antiplatelet treatment in antiplatelet-resistant patients were identified through a literature search: PubMed, EMBASE, Web of Science and the Cochrane Library. The primary endpoint was the composite of death from any cause and stent thrombosis. All total clinical adverse events and bleeding complications were evaluated. Results Data were combined across seven randomised studies comprising 12 048 subjects, of whom 3738 (31.0%) were found to be antiplatelet-resistant. Antiplatelet-resistant patients provided with tailored antiplatelet therapy showed less risk of death or stent thrombosis than those assigned conventional antiplatelet treatment (0.5% vs 2.2%; OR (95% CI) 0.25 (0.13 to 0.49), p<0.0001). A significant benefit in terms of total adverse event risk reduction was observed during follow-up for tailored vs conventional antiplatelet therapy (5.5% vs 10.0%; OR (95% CI) 0.40 (0.20 to 0.77), p=0.006). No statistical difference in bleeding complications was observed between these two groups (p=0.08). Conclusions In the study, personalised antiplatelet treatment for antiplatelet resistance was found to be associated with less occurrence of death or stent thrombosis and the less risk of total clinical adverse events than conventional treatment, without increasing the risk of bleeding complications.