Comparative effects of different antiplatelet strategies in carriers of CYP2C19 loss-of-function alleles: a network meta-analysis
Authors' conclusion
Among carriers of CYP2C19 LoF alleles undergoing PCI, standard-dose prasugrel or ticagrelor are most effective in reducing platelet reactivity, while double-dose clopidogrel and additional cilostazol showed modest effects.
Study context
- Population
- Carriers of CYP2C19 loss-of-function alleles undergoing percutaneous coronary interventions (PCI)12 randomized controlled trials (RCTs)
- Comparison
- Alternative oral antiplatelet strategies vs standard-dose clopidogrel
- Outcome
- Platelet reactivity by VerifyNow, as P2Y12 reaction units (P2Y12 reaction unit (PRU))
Methodological detailsfrequentist
- Frequentist
Pooled result
As reported in the abstract
PRU
Each group vs clopidogrel 75 mgMD (95% CI)
Prasugrel 10 mg
−127.91(−141.04 to −114.78)
Ticagrelor 90 mg bid
−124.91(−161.78 to −88.04)
Prasugrel 5 mg
−76.33(−98.01 to −54.65)
Prasugrel 3.75 mg
−73.00(−100.28 to −45.72)
Cilostazol 100 mg bid
−42.64(−64.72 to −20.57)
Clopidogrel 150 mg
−32.11(−51.33 to −12.90)
Original publication
Comparative effects of different antiplatelet strategies in carriers of CYP2C19 loss-of-function alleles: a network meta-analysis. Eur Heart J Cardiovasc Pharmacother. Published 16 May 2024. doi:10.
Summarised from the published abstract; every number is checked against it