In a nutshell
This study evaluated whether antiplatelet therapy after percutaneous coronary intervention (PCI) should be given personalized for each patient. It found that guided therapy resulted in a reduction in the overall risk of heart attack, stroke, and death compared to standard therapy.
Some background
Percutaneous coronary intervention (PCI) is a procedure used to unblock blood vessels in the heart. It usually involves placing a stent in the blood vessel to keep it open. One problem with stents is that blood clots can form on them and cause another blockage. Therefore, patients are treated with antiplatelet medications after a PCI to reduce blood clotting and reduce the risk of this happening.
Different antiplatelet medications are available. Patients usually receive standard therapy, which means all patients attending a particular doctor/ hospital receive the same treatment regimen. However, it is possible to design a guided treatment regimen for individual patients based on their platelet levels and some genetic factors. It is not clear if guided therapy is more effective than standard therapy after a PCI.
Methods & findings
This study looked at 14 previous studies, involving a total of 20,743 patients. Patients were treated with either standard or guided antiplatelet therapy following a PCI procedure. Guided therapy regimes were designed based on individual platelet levels or genetic testing.
Patients on guided antiplatelet treatment were 22% less likely to suffer from a heart attack, stroke, or death compared to those on standard therapy. Guided antiplatelet therapy also slightly reduced the risk of bleeding by 12% compared to standard therapy.
Compared to the standard therapy group, those on guided therapy were 23% less likely to suffer from heart-related death, 24% less likely to suffer a heart attack, and 36% less likely to suffer a stroke.
The bottom line
This study showed that guided antiplatelet therapy may improve outcomes after PCI compared to standard therapy.
The fine print
Some of the studies reviewed in this study did not include full patient-specific information which would have been useful.
Published By :
Lancet (London, England)
Date :
Apr 17, 2021
