Background: High on-treatment platelet reactivity (HPR) represents a strong risk factor for thrombotic events after\nPCI. We aim to evaluate the efficacy and safety of individualizing intensified dual antiplatelet therapy (DAPT) in\nPCI-treated patients with HPR based on platelet function testing (PFT).\nMethods: Electronic databases were searched for randomized control trials that reported the clinical outcomes of\nusing an intensified antiplatelet protocol with P2Y12 receptor inhibitor comparing with standard maintenance dose\nof clopidogrel on the basis of platelet function testing. Clinical endpoints were assessed.\nResults: From 2005 to 2016, thirteen clinical studies comprising 7290 patients were included for analysis. Compared\nwith standard antiplatelet therapy with clopidogrel, the intensified protocol based on platelet function testing was\nassociated with a significant reduction in major adverse cardiovascular events (RR:0.55, 95% CI: 0.36ââ?¬â??0.84, p = 0.005),\ncardiovascular death (RR:0.60, 95% CI: 0.38ââ?¬â??0.96, p = 0.03), stent thrombosis (RR:0.58, 95% CI: 0.36ââ?¬â??0.93, p = 0.02) and\ntarget vessel revascularization (RR:0.33, 95% CI: 0.14ââ?¬â??0.76, p = 0.009). No significant difference was found in the rate\nof bleeding events between intensified and standard protocol.\nConclusions: Compared with standard clopidogrel therapy, individualized intensified antiplatelet therapy on the\nbasis of platelet reactivity testing reduces the incidence of cardiovascular events in patient undergoing PCI, without\nincreasing the risk of bleeding
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