Background: Patients after percutaneous coronary intervention (PCI) are given the standard dual antiplatelet therapy of aspirin and clopidogrel. However the responses to clopidogrel are subject to variation. The aim of this study was to systematically review the efficacy and safety of platelet function monitoring to adjust antiplatelet therapy after PCI.
Methods: Relevant studies between 2008 and 2016 were searched to find prospective, randomized trials that reported the clinical impact of using an adenosine diphosphate (ADP)-specific platelet function assay compared to standard-dose clopidogrel, and followed up by 6 or 12 months. clopidogrel responsiveness was assessed by using VerifyNow, Multiplate, VASP or light transmission aggregometry. Evaluated efficacy measures included major adverse cardiovascular events (MACE) cardiovascular(CV) death, death from all cause, non-fatal myocardial infarction (MI), urgency target vessel revascularization (UTVR) and definite/ probable stent thrombosis (ST), while major bleeding events were recorded as safety endpoint.
Result: 6 clinical trials comprising a total number of 3307 randomized patients followed up by 6 months and 4 clinical trials with 3697 randomized patients followed up by 12 months were included, Compared to standard clopidogrel therapy, There was no difference in the rate of MACE, CV, MI, UTVR, ST and major bleeding events in the monitoring group (all p>0.05) both by 6 months and 12 months’ follow up.
Conclusions: In this collaborative meta-analysis, platelet function tests have no effect on patients of clinical impact with 6 months and 12 months follow up.