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Does individualized guided selection of antiplatelet therapy improve outcomes after percutaneous coronary intervention? A systematic review and meta-analysis.
Yamani, Naser; Unzek, Samuel; Mankani, Muhammad Hasnain; Almas, Talal; Musheer, Adeena; Qamar, Humera; Farooq, Shausha; Shahnawaz, Waqas; Fatima, Kaneez; Figueredo, Vincent; Mookadam, Farouk.
Afiliación
  • Yamani N; Department of Medicine, John H Stroger Jr. Hospital of Cook County, Chicago, IL, USA.
  • Unzek S; Department of Cardiac Imaging, Banner University Medical Centre, Phoenix, AZ, USA.
  • Mankani MH; Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.
  • Almas T; Department of Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
  • Musheer A; Department of Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
  • Qamar H; Department of Medicine, Khaja Bandanawaz Institute of Medical Sciences Gulbarga, India.
  • Farooq S; Department of Medicine, Ziauddin University Hospital, Karachi, Pakistan.
  • Shahnawaz W; Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.
  • Fatima K; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
  • Figueredo V; Department of Cardiology, St.Mary Medical Center, Langhorne, PA, USA.
  • Mookadam F; Department of Cardio Oncology, Banner University Medical Centre, Phoenix, AZ, USA.
Ann Med Surg (Lond) ; 79: 103964, 2022 Jul.
Article en En | MEDLINE | ID: mdl-35860051
Background: The potential benefits of individualized guided selection of antiplatelet therapy over standard antiplatelet therapy in improving outcomes in patients undergoing percutaneous coronary intervention (PCI) have not been established. Therefore, we pooled evidence from available clinical trials to assess the effectiveness by comparing the two regimens in patients undergoing PCI. Methods: We queried two electronic databases, MEDLINE and Cochrane CENTRAL, from their inception to April 20, 2021 for published randomized controlled trials in any language that compared guided antiplatelet therapy, using either genetic testing or platelet function testing, versus standard antiplatelet therapy in patients undergoing PCI. The results from trials were presented as risk ratios (RRs) with 95% confidence intervals (CIs) and were pooled using a random-effects model. Results: Eleven eligible studies consisting of 18,465 patients undergoing PCI were included. Pooled results indicated that guided antiplatelet therapy, compared to standard therapy, was associated with a significant reduction in the incidence of MACE [RR 0·78, 95% CI (0·62-0·99), P = 0·04], MI [RR 0·73, 95% CI (0·56-0.96), P = 0·03], ST [RR 0·66, 95% CI (0·47-0.94), P = 0·02], stroke [RR 0·71, 95% CI (0·50-1.00), P = 0·05], and minor bleeding [RR 0·78, 95% CI (0·66-0.91), P = 0·003]. Conclusions: Individualized guided selection of antiplatelet therapy significantly reduced the incidence of MACE, MI, ST, stroke, and minor bleeding in adult patients when compared with standard antiplatelet therapy. Our findings support the implementation of genetic and platelet function testing to select the most beneficial antiplatelet agent.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Prognostic_studies / Systematic_reviews Idioma: En Revista: Ann Med Surg (Lond) Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Prognostic_studies / Systematic_reviews Idioma: En Revista: Ann Med Surg (Lond) Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido