Table 4

Meta-analyses evaluating the relation between poor response to clopidogrel and clinical outcome in PCI

Meta-analysesPopulationTypes of included studiesNo of studies/sizePoor responders, %AssaysOutcome
Snoep et al49  PCI Any observational studies/sub-analyses of RCT 25, n = 3688 21 LTA, VASP, flow cytometry of platelet-bound fibrinogen Composite MACE 
 OR = 8.00 (3.36-19.05) 
Stent thrombosis 
 OR = 7.03 (0.63-79.01) 
Clinical ischemic events 
 OR = 12.02 (5.91-24.42) 
Sofi et al50  PCI; 5 stable CAD-only studies Prospective observational studies/sub-analyses of RCT 14, n = 4564 26.4 LTA, VASP, VerifyNow P2Y12 Composite MACE 
 OR = 5.67 (2.97- 10.84) 
Aradi et al51  PCI; 4 stable CAD-only studies Prospective observational studies/sub-analyses of RCT 20, n = 9187 33.2 LTA, VASP, VerifyNow P2Y12, MEA Composite MACE 
 OR = 4.95 (3.34-7.34) 
Stent thrombosis 
 OR = 4.14 (2.74-6.25) 
Cardiovascular death 
 OR = 3.35 (2.39-4.70) 
Non-fatal MI 
 OR = 3.00 (2.26-3.99) 
Brar et al52  PCI; 1 stable CAD-only study Only prospective studies involving VerifyNow P2Y12 assay 6, n = 3059 37.1 VerifyNow P2Y12 assay only For PRU cutoff >230 U 
Individual patient data meta-analysis Composite MACE 
 HR = 2.10 (1.62-2.73) 
Stent thrombosis 
 HR = 3.11 (1.50–6.46) 
Death 
 HR = 1.66 (1.04-2.68) 
Yamaguchi et al53  PCI (98.5%) Only prospective studies involving VerifyNow P2Y12 assay 8, n = 4817 46.4 VerifyNow P2Y12 assay only Composite MACE 
 OR = 3.05 (2.33-3.98) 
Stent thrombosis 
 OR = 3.26 (1.63-6.51) 
Death 
 OR = 2.00 (1.22-3.27) 
Meta-analysesPopulationTypes of included studiesNo of studies/sizePoor responders, %AssaysOutcome
Snoep et al49  PCI Any observational studies/sub-analyses of RCT 25, n = 3688 21 LTA, VASP, flow cytometry of platelet-bound fibrinogen Composite MACE 
 OR = 8.00 (3.36-19.05) 
Stent thrombosis 
 OR = 7.03 (0.63-79.01) 
Clinical ischemic events 
 OR = 12.02 (5.91-24.42) 
Sofi et al50  PCI; 5 stable CAD-only studies Prospective observational studies/sub-analyses of RCT 14, n = 4564 26.4 LTA, VASP, VerifyNow P2Y12 Composite MACE 
 OR = 5.67 (2.97- 10.84) 
Aradi et al51  PCI; 4 stable CAD-only studies Prospective observational studies/sub-analyses of RCT 20, n = 9187 33.2 LTA, VASP, VerifyNow P2Y12, MEA Composite MACE 
 OR = 4.95 (3.34-7.34) 
Stent thrombosis 
 OR = 4.14 (2.74-6.25) 
Cardiovascular death 
 OR = 3.35 (2.39-4.70) 
Non-fatal MI 
 OR = 3.00 (2.26-3.99) 
Brar et al52  PCI; 1 stable CAD-only study Only prospective studies involving VerifyNow P2Y12 assay 6, n = 3059 37.1 VerifyNow P2Y12 assay only For PRU cutoff >230 U 
Individual patient data meta-analysis Composite MACE 
 HR = 2.10 (1.62-2.73) 
Stent thrombosis 
 HR = 3.11 (1.50–6.46) 
Death 
 HR = 1.66 (1.04-2.68) 
Yamaguchi et al53  PCI (98.5%) Only prospective studies involving VerifyNow P2Y12 assay 8, n = 4817 46.4 VerifyNow P2Y12 assay only Composite MACE 
 OR = 3.05 (2.33-3.98) 
Stent thrombosis 
 OR = 3.26 (1.63-6.51) 
Death 
 OR = 2.00 (1.22-3.27) 
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