{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:20:43Z","timestamp":1792005643575,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,11,7]],"date-time":"2018-11-07T00:00:00Z","timestamp":1541548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to evaluate the efficacy and safety of personalized genotype\u2010guided selection of antiplatelet therapy versus standard of care in patients undergoing percutaneous coronary intervention (PCI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Clopidogrel is the most frequently used P2Y<jats:sub>12<\/jats:sub> receptor antagonist in patients with coronary artery disease. However, genetic variations of clopidogrel are associated with inter\u2010individual response variability which could limit its efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Electronic databases were searched for all randomized clinical trials (RCTs) evaluating genotype\u2010guided therapy versus standard of care in patients undergoing stent implantation. Aggregated risk ratios (RRs) and 95% CIs were calculated using a random\u2010effects model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 6 RCTs with a total of 2,371 patients. When compared with standard of care, the use of genotype\u2010guided therapy did not significantly reduce major adverse cardiovascular events (MACE) (RR 0.67; 95% CI: 0.35\u20131.27; <jats:italic>P<\/jats:italic> = 0.22). However, MACE was significantly reduced in the subset of trials which enrolled only acute coronary syndromes (ACS) (<jats:italic>P<\/jats:italic> &lt; 0.01). In addition, there was a significant reduction in myocardial infarction in the genotype\u2010guided group (RR 0.44; 95% CI: 0.28\u20130.70; <jats:italic>P<\/jats:italic> &lt; 0.01; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 0%). Other clinical outcomes were not significantly different: cardiovascular mortality (RR 0.68; 95% CI: 0.27\u20131.74; <jats:italic>P<\/jats:italic> = 0.42), stroke (RR 0.62; 95% CI: 0.23\u20131.65; <jats:italic>P<\/jats:italic> = 0.34), stent thrombosis (RR 0.37; 95% CI: 0.13\u20131.06; <jats:italic>P<\/jats:italic> = 0.06), and bleeding (RR 0.68; 95% CI: 0.43\u20131.06; <jats:italic>P<\/jats:italic> = 0.09).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients undergoing stent implantation, MACE with genotype\u2010guided therapy was not significantly reduced; however, there was a signal towards reduction of MACE in ACS patients, as well as a lower rate of MI, though this will require further confirmation in adequately powered trials.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.27949","type":"journal-article","created":{"date-parts":[[2018,11,7]],"date-time":"2018-11-07T10:18:30Z","timestamp":1541585910000},"page":"1246-1252","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["<i>CYP2C19<\/i> pharmacogenetics versus standard of care dosing for selecting antiplatelet therapy in patients with coronary artery disease: A meta\u2010analysis of randomized clinical trials"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1747-2859","authenticated-orcid":false,"given":"Babikir","family":"Kheiri","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Hurley Medical Center\/Michigan State University  Flint Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Osman","sequence":"additional","affiliation":[{"name":"Division of Cardiology West Virginia University School of Medicine  Morgantown West Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Abdalla","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Hurley Medical Center\/Michigan State University  Flint Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"Haykal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Hurley Medical Center\/Michigan State University  Flint Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranay V.","family":"Pandrangi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Spectrum Health\/Michigan State University  Grand Rapids Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Chahine","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Hurley Medical Center\/Michigan State University  Flint 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