Prognostic significance of high on-clopidogrel platelet reactivity after percutaneous coronary intervention: systematic review and meta-analysis.
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.
Twenty studies , 9,187 patients
High on-clopidogrel platelet reactivity
MI: 3.00 [2.26-3.99,
P < .00001 for all cases
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.
Definition of HPR between studies