Trial | Cohort | Definition of HTPR | Platelet reactivity assay | Quality of study* |
---|---|---|---|---|
ACCEL-AMI29 | Patients with ACS undergoing PCI | 5 and 20 μM ADP-induced maximal platelet aggregation >50% | VerifyNow P2Y12; LTA | +++ |
ACCEL-LOADING-ACS30 | Patients with non-ST-elevation MI undergoing PCI | NR | VerifyNow P2Y12 | ±±± |
ACCEL-POLYMORPHISM31 | Patients with high post-treatment platelet reactivity or diabetes undergoing PCI | 5 μM ADP-induced maximal platelet aggregation >50% | VerifyNow P2Y12; LTA | +++ |
ACCEL-PPI32 | Patients with acute MI undergoing PCI | 20 μM ADP-induced maximal platelet aggregation >59% | LTA | ±±± |
ACCEL-RESISTANCE33 | Patients with high on-treatment platelet reactivity undergoing PCI | 5 μM ADP-induced maximal platelet aggregation >50% | VerifyNow P2Y12; LTA | ++± |
CILON-T34 | Patients with angina undergoing PCI | NR | VerifyNow P2Y12 | ++± |
Gao et al35 | Obese patients undergoing PCI | Post-treatment platelet aggregation absolute difference 10% or less | LTA | ±±± |
Guan et al36 | Patients with ACS and high on-treatment platelet reactivity undergoing PCI | 20 μM ADP-induced maximal platelet aggregation >55% | LTA | ±±± |
HOST-ASSURE37 | All-comer patients undergoing PCI | NR | VerifyNow P2Y12 | ±±+ |
Jeong et al38 | Patients with ACS undergoing PCI | NR | LTA | ±±± |
Jin et al39 | Patients undergoing PCI | % platelet inhibition <20 | VerifyNow P2Y12; LTA | ±++ |
Kim et al40 | Patients with acute MI undergoing PCI | 20 μM ADP-induced maximal platelet aggregation >59% | VerifyNow P2Y12; LTA | ++± |
Kim et al41 | Patients with ST-elevation MI undergoing PCI | % platelet inhibition <20 | VerifyNow P2Y12; LTA | ±±± |
Kum et al42 | Patients undergoing PCI | NR | VerifyNow P2Y12 | ±±± |
Lee et al43 | Patients with high on-treatment platelet reactivity undergoing PCI | % platelet inhibition <20 | VerifyNow P2Y12 | +±± |
PIANO-2 CKD44 | Patients with renal disease on haemodialysis undergoing PCI | 5 μM ADP-induced maximal platelet aggregation >50% | VerifyNow P2Y12; LTA | +++ |
Shim et al45 | Patients undergoing PCI with DES | % platelet inhibition <20 | VerifyNow P2Y12 | +±± |
*Represents risk of bias based on: sequence generation of allocation; allocation concealment and blinding. ‘+’ represents low bias risk, ‘−’ high bias risk and ‘±’ unclear bias risk.
ACCEL-AMI, adjunctive Cilostazol versus High Maintenance Dose Clopidogrel in patients with AMI; ACCEL-LOADING-ACS, Multicentre Randomised Trial Evaluating Efficacy of Cilostazol on Platelet Aggregation, Inflammation and Myonecrosis in ACS Patients; ACCEL-POLYMORPHISM, Cytochrome 2C19 Polymorphism and Response to Adjunctive Cilostazol versus High Maintenance-Dose Clopidogrel in Patients Undergoing Percutaneous Coronary Intervention; ACCEL-PPI, Pharmacodynamics Effects of Adding Cilostazol versus Double-dose Clopidogrel in Patients with Acute Myocardial Infarction During Proton Pump Inhibitor Co-administration; ACCEL-RESISTANCE, Adjunctive Cilostazol Versus High Maintenance Dose Clopidogrel in Patients with Clopidogrel Resistance; ACS, acute coronary syndrome; CILON-T, Influence of Cilostazol-based Triple Antiplatelet Therapy on Ischaemic Complication After Drug-eluting Stent Implantation; HD, high-dose clopidogrel (150 mg); HOST-ASSURE, Harmonising Optimal Strategy for Treatment of Coronary Artery Stenosis—Safety and Effectiveness of Drug-Eluting Stents and Antiplatelet Regimen; LTA, light transmittance aggregometry; MI, myocardial infarction; NR, not reported; PIANO-2 CKD, Platelet Reactivity in Patients with Chronic Kidney Disease Receiving Adjunctive Cilostazol Compared with a High-Maintenance Dose of Clopidogrel; SD, Standard-dose clopidogrel (75 mg).