| ABSTRACT Objective: To evaluate the effects and safety of Genotype-guided anti platelet therapy compared to routine therapy in patients with acute coronary syndromes (ACS) after percutaneous coronary intervention (PCI) by Meta analyses. Methods:The studies evaluating the clinical utility of Genotype-guided anti platelet therapy were retrieved through the systematically search on Embase, PubMed, Cochrane Library, ClinicalTrials.gov and three Chinese literature databases (up to Jan 2016). The incidence rate of major adverse cardiovascular events (MACE), including death, myocardial infarction (MI) and target vessel revascularization (TVR), and bleeding events, were extracted and meta analyses was performed by using RevMan 5.3. Results: Three studies were included in this Meta analysis, involving 1 254 patients with acute coronary syndromes (ACS) after percutaneous coronary intervention (PCI) who were prescribed anti platelet therapy. Compared to the routine therapy arm, the incidence rate of MACE was significantly lower in Genotype-guided anti platelet therapy arm at 1 month, 6 and 8 months and 12 months after PCI (P<0.05)；the incidence rate of MI was significantly lower in Genotype-guided anti platelet therapy arm at 1，6 and 8 months after PCI (P<0.05)；the incidence rate of TVR was significantly lower in Genotype-guided anti platelet therapy arm at 1 month after PCI(P<0.05) ; between the two arms, there was no significant difference in the incidence rate of death and bleeding events at 1，6，8 and 12 months after PCI(P>0.05). Conclusion: CYP2C19 Genotype-guided anti platelet therapy significantly improved the outcomes of patients with ACS after PCI, the incidence rate of MACE, MI, TVR were significantly decreased within the first year after PCI. However, the routine CYP2C19 Genotype-guided anti platelet therapy needed more evidences, especially the cost effectiveness evaluation. |
