Study | Dual antiplatelet therapy ≥30 days | Aspirin as primary agent (dose × no of patients) | Second antiplatelet agent (no of patients; dose) | Mandatory PFT (no of patients) | PFT ranges for satisfactory inhibition |
Martinez-Galdamez, 2018 | Yes | Yes (75 mg × 10, 80 mg × 4, 100 mg × 32, 200 mg × 2, 325 mg × 2) | Clopidogrel (47/50; 75 mg x 45/47) Prasugrel (3/50; 10 mg × 2/3, 5 mg × 1/3) | No (21/50) | ARU <550 PRU 60–240 VerifyNow |
Brasiliense, 2018 | Yes | Yes (NR × 205/205) | NR (NR) | No (NR) | N/A |
Lin, 2018 | Yes | Yes (325 mg × 47/47) | Clopidogrel (75 mg × 47/47) | No (NR) | N/A |
Colby, 2018 | Yes | Yes (325 mg × 294/294) | Clopidogrel (75 mg × NR) | No (NR) | No change if PRU >200 VerifyNow |
Oishi, 2018 | Yes | Yes (100 mg × 94/94) | Clopidogrel (50–75 mg × 94/94) If PFT unsatisfactory: clopidogrel and Cliostazol (100–150+100–200 mg) | Yes (94/94) | ARU <550 PRU <230 VerifyNow |
Le, 2017 | Yes | Yes (81–325 mg × 38/38) | Clopidogrel (dose titrated to PRU levels on PFT) | Yes (38/38) | PRU 60–200 VerifyNow |
Hanel, 2017 | Yes | Yes (NR) | NR | NR | NR |
Pereira, 2015 | Yes | Yes (100 mg × 10/10) | Clopidogrel (75 mg × 10/10) If PFT unsatisfactory: loading dose clopidogrel 600 mg and repeat PFT | Yes (10/10) | 40% P2Y12 inhibition VerifyNow |
Subgroup analysis | |||||
Mandatory PFT | No of treatments | Deaths (%) | All major complications (major stroke, sICH, death) | Meta-analysis: all major complications | I2 Harbord (p value) |
Yes (3 studies) | 142 | 1 | 3 | 2.5% (0.6–5.7) | 0% −1.304 (0.446) |
No or NR (5 studies) | 759 | 4 | 11 | 1.6% (0.9–2.7) | 0% −1.481 (0.043) |
ARU, aspirin reactivity units; N/A, not applicable; NR, not reported; PFT, platelet function testing; PRU, P2Y12 reactivity units; sICH, symptomatic intracerebral hemorrhage.