| Personalized antiplatelet treatment after percutaneous coronary intervention: The MADONNA study. | |
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MedLine Citation:
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PMID: 22656044 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVES: Clopidogrel non-responsiveness is associated with adverse clinical outcome. We aimed to investigate whether individualized antiplatelet treatment in clopidogrel non-responders is an effective and safe strategy. METHODS: This was a prospective non-randomized non-blinded study comparing two cohorts (guided and non-guided treatment) with a follow-up of 1-month. Responsiveness to clopidogrel was assessed by multiple electrode aggregometry (MEA) in 798 patients with coronary artery disease undergoing percutaneous coronary intervention (PCI). In the guided group (n=403) clopidogrel non-responders received repeated loading doses of clopidogrel or prasugrel, in the non-guided group (n=395) clopidogrel non-responders did not undergo any change in treatment. RESULTS: Stent thrombosis occurred significantly less often in the guided group than in the non-guided group (0.2% vs. 1.9%; p=0.027). The multivariate Cox regression analysis showed that patients in the non-guided group were at a 7.9-fold higher risk to develop stent thrombosis compared to the guided group (OR: 7.9; 95% CI: 1.08-69.2; p=0.048). In line with this, acute coronary syndrome occurred significantly less often in the guided group than in the non-guided group (0% vs. 2.5%; p=0.001) whereas there was no difference in the event rates of cardiac death (2% vs. 1.3%; p=0.422) or major bleedings (1% vs. 0.3%; p=0.186). CONCLUSION: Personalized antiplatelet treatment according to the platelet function testing with MEA resulted in an improved efficacy with an equal safety compared to the standard treatment. |
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Authors:
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Jolanta M Siller-Matula; Marcel Francesconi; Cornelia Dechant; Bernd Jilma; Gerald Maurer; Georg Delle-Karth; Ghazaleh Gouya; Katharina Ruzicka; Andrea Podczeck-Schweighofer; Günter Christ |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-5-30 |
Journal Detail:
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Title: International journal of cardiology Volume: - ISSN: 1874-1754 ISO Abbreviation: - Publication Date: 2012 May |
Date Detail:
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Created Date: 2012-6-4 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Department of Cardiology, Medical University of Vienna, Austria. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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