2013
DOI: 10.1016/j.ijcard.2012.05.040
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Personalized antiplatelet treatment after percutaneous coronary intervention: The MADONNA study

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Cited by 104 publications
(82 citation statements)
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“…Although these new drugs undoubtedly decrease the risk of thrombotic complications, they also increase the risk of bleeding complications (2,3). In order to decrease the risk of both thrombotic and bleeding complications, it might be rational in some patients to tailor the antiplatelet treatment, as evidenced by the MADONNA study (4). It can be inferred that tailored antiplatelet treatment is effective in some high-risk groups of patients, and identification of such risks will be essential for routine clinical use.…”
mentioning
confidence: 99%
“…Although these new drugs undoubtedly decrease the risk of thrombotic complications, they also increase the risk of bleeding complications (2,3). In order to decrease the risk of both thrombotic and bleeding complications, it might be rational in some patients to tailor the antiplatelet treatment, as evidenced by the MADONNA study (4). It can be inferred that tailored antiplatelet treatment is effective in some high-risk groups of patients, and identification of such risks will be essential for routine clinical use.…”
mentioning
confidence: 99%
“…The study demonstrated the benefit of tailored antiplatelet therapy in that stent thrombosis and acute coronary syndrome occurred significantly less often in the guided group [26]. In another study, low platelet reactivity identified using the MEA seemed to be as effective as assessment of CYP450 variants in identifying patients undergoing coronary stent placement with an increased bleeding risk, although in this case the expected relationship between high platelet reactivity and stent thrombosis was not evident [27].…”
Section: Multiplate Electrode Aggregometrymentioning
confidence: 95%
“…31 A recent smaller study of 800 patients demonstrated a reduction in the rates of in-stent thrombosis when patients with high on-treatment platelet reactivity re-ceived repeated loading doses of antiplatelet drugs. 32 Further small studies of approximately 200 -300 subjects have subsequently been performed, by using various different tests of platelet function and various alterations to treatment in poor responders, and have shown some success. [33][34][35][36] A recent meta-analysis 37 of some of these trials demonstrated an overall reduction in mortality and stent thrombosis with modification of antiplatelet therapy on the basis of platelet function testing, though the tests and modifications used were disparate and the overall benefit was highly dependent on the background risk of stent thrombosis (which may be lower in neurovascular patients).…”
Section: Assumptionmentioning
confidence: 99%