Key result
Guided intensification of P2Y12 inhibition reduced 30-day death or stent thrombosis vs historical controls in PCI patients with high platelet reactivity (HR 0.32; 95% CI 0.13-0.79; p=0.009).
Why the study?
Does platelet function testing-guided therapy with selective intensification of P2Y12 receptor inhibition reduce the composite of death or stent thrombosis in clopidogrel-treated patients undergoing PCI with high platelet reactivity?
Cohort (n=999)
Does platelet function testing-guided therapy with selective intensification of P2Y12 receptor inhibition reduce the composite of death or stent thrombosis in clopidogrel-treated patients undergoing PCI with high platelet reactivity?
Hazard Ratio: 0.32 (95% CI 0.13–0.79)
Absolute Event Rate: 1.2% vs 3.7%
p-value: p=0.009
In PCI patients with high on-clopidogrel platelet reactivity, a platelet function testing-guided strategy to intensify P2Y12 inhibition significantly reduced 30-day death or stent thrombosis compared to a historical control.
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Supports personalized P2Y12 intensification in high-reactivity PCI; hypothesis-generating and requires RCTs before adoption.
A 2014 study conducted a cohort in High on-clopidogrel platelet reactivity in patients undergoing PCI (n=999). Guided therapy with selective intensification of P2Y12 receptor directed treatment vs. Historical control cohort without a change of treatment based on platelet function testing was evaluated on Composite of death from any cause or stent thrombosis after 30 days (HR 0.32, 95% CI 0.13-0.79, p=0.009). Guided intensification of P2Y12 inhibition reduced 30-day death or stent thrombosis vs historical controls in PCI patients with high platelet reactivity (HR 0.32; 95% CI 0.13-0.79; p=0.009).
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