Personalized antiplatelet therapy in patients with coronary artery disease undergoing percutaneous coronary intervention: A network meta-analysis of randomized clinical trials.

Journal Article (Systematic Review;Journal Article)


This study aimed to evaluate the efficacy and safety of genotype- and phenotype-guided intensified antiplatelet therapy compared with conventional therapy in patients undergoing stent implantation.


Although potent P2Y12 receptor inhibitors are recommended for percutaneous coronary intervention (PCI)-treated acute coronary syndrome, their usage is limited by a high bleeding risk. Therefore, personalized antiplatelet therapy could provide a valuable foundation for selection of antiplatelet therapy in this population.


We conducted a Bayesian network meta-analysis for all randomized clinical trials (RCTs) that evaluated genotype- and/or phenotype-guided therapy in PCI-treated coronary artery disease.


Thirteen RCTs were included with a total of 6,845 patients. The results showed no significant differences in major adverse cardiovascular events (MACE) between the treatment options ((genotype guided vs. standard of care; OR 0.64; 95% CI: 0.38-1.05) and (phenotype vs. standard of care; OR 0.93; 95% CI: 0.54-1.37)). In addition, no significant differences were demonstrated in bleeding events ((genotype guided vs. standard of care; OR 0.73; 95% CI: 0.45-1.25) and (phenotype vs. standard of care; OR 0.90; 95% CI: 0.62-1.39)).


In this mixed treatment meta-analysis of RCTs, neither genotype- nor phenotype-guided antiplatelet therapy in patients with PCI-treated coronary artery disease was superior to conventional therapy.

Full Text

Duke Authors

Cited Authors

  • Kheiri, B; Abdalla, A; Osman, M; Barbarawi, M; Zayed, Y; Haykal, T; Chahine, A; Bachuwa, G; Hassan, M; Bhatt, DL

Published Date

  • August 2019

Published In

Volume / Issue

  • 94 / 2

Start / End Page

  • 181 - 186

PubMed ID

  • 30628754

Electronic International Standard Serial Number (EISSN)

  • 1522-726X

International Standard Serial Number (ISSN)

  • 1522-1946

Digital Object Identifier (DOI)

  • 10.1002/ccd.28075


  • eng