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Aradi D , et al Am Heart J. 2010 Sep;160(3):543-51.

Prognostic significance of high on-clopidogrel platelet reactivity after percutaneous coronary intervention: systematic review and meta-analysis.

METHODS

Systematic review and meta-analysis on the clinical relevance of HPR , observation studies 2003-2010

Outcome measures : cardiovascular (CV) death, definite/probable stent thrombosis (ST), nonfatal myocardial infarction (MI), and a composite end point of reported ischemic events.

RESULTS

Twenty studies , 9,187 patients

High on-clopidogrel platelet reactivity

MI: 3.00 [2.26-3.99,

STEMI:4.14 [2.74-6.25]

Composite:4.95 [3.34-7.34]

P < .00001 for all cases

CONCLUSIONS:

According to the meta-analysis, patients with HPR had a 3.4-fold higher risk for CV death compared with patients with normal ADP reactivity (odds ratio 3.35, 95% CI 2.39-4.70, P < .00001).

High on-clopidogrel platelet reactivity, measured by an ADP-specific platelet function assay, is a strong predictor of CV death, MI, and ST in patients after percutaneous coronary intervention.

ISSUES

Methodology

Definition of HPR between studies

Meta-analysis/Review

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