Evidence map›Paper›PMID 40788330›Full record

SynthesisCardiovascular drugs and therapy2026

Optimizing P2Y12 Inhibitor Therapy in Post-PCI Patients Through Genotype-Guided Strategies: A Systematic Review and Meta-Analysis.

Mohammad Hamza, Mubashar Karamat, Khaled M Harmouch, Sardar M Alamzaib, Sidra Jabeen, Jawad Basit, Karan Bhanushali, Rohan Ved, Amna Rashdi, Muhammad Usman Almani and 3 more

Abstract readSystematic ReviewMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Cardiovascular drugs and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Mohammad HamzaDepartment of Internal Medicine, Guthrie Medical Group, New York, NY, USA.
Mubashar KaramatDepartment of Internal Medicine, Ascension Saint Francis Hospital, Evanston, IL, USA.
Khaled M HarmouchDepartment of Internal Medicine, Detroit Medical Center/Wayne State University, Detroit, MI, USA.
Sardar M AlamzaibUniversity of Texas Health Science Center at Houston, Houston, TX, USA.
Sidra JabeenDepartment of Internal Medicine, Liaquat National Hospital and Medical College, Karachi, Pakistan.
Jawad BasitDepartment of Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan.
Karan BhanushaliDepartment of Internal Medicine, Roger Williams Medical Center, Providence, RI, USA.
Rohan VedMichigan State University College of Osteopathic Medicine, East Lansing, MI, USA.
Amna RashdiWindsor Heart Institute, Windsor, Canada.
Muhammad Usman AlmaniDepartment of Cardiology, Einstein Healthcare Network Philadelphia, Philadelphia, PA, USA.
Moinuddin SyedDetroit Medical Center, Detroit, MI, USA.
Yasar SattarDepartment of Cardiology, West Virginia University, Morgantown, WV, USA.
M Chadi AlraiesCardiovascular Institute, Detroit Medical Center, Wayne State University, DMC Heart Hospital, 311 Mack Ave, Detroit, MI, 48201, USA. alraies@hotmail.com.ORCID 0000-0002-7874-4566

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClopidogrel non-responder is a common dilemma in the management of post-percutaneous coronary intervention (PCI) management. Clopidogrel is metabolized by CYP2C19. The genetic variations in CYP2C19 can affect the efficacy and bioavailability of the drug that can be checked via genotype testing of the gene. This study evaluates the impact of genotype versus conventional guided P2Y12 inhibitor therapy on post-PCI patient outcomes.

methodsGuided by PRISMA and AMSTAR-2, we analyzed 10 trials comparing genotype-guided and conventional P2Y12 inhibitor therapy in post-PCI patients. Our search, spanning up to October 2022 across major databases, focused on adult populations undergoing PCI, assessing outcomes like mortality, MACE, myocardial infarction, stroke, stent thrombosis, and bleeding events.

resultsA total of 10 studies involving 4300 patients were selected in pooled analysis, genotype-guided therapy markedly reduced all-cause mortality (RR: 0.59; 95% CI: 0.37-0.95) and MACE (RR: 0.66; 95% CI: 0.49-0.88), without a significant increase in bleeding events (RR: 0.83; 95% CI: 0.61-1.14). Furthermore, significant reductions were observed in myocardial infarction (RR: 0.59; 95% CI: 0.44-0.78) and stent thrombosis (RR: 0.55; 95% CI: 0.3-0.996), with stroke also seeing a decrease (RR: 0.56; 95% CI: 0.35-0.9).

conclusionGenotype-guided P2Y12 inhibitor therapy significantly improves outcomes for post-PCI patients, reducing mortality, MACE, myocardial infarction, and stent thrombosis without increasing bleeding risk. These findings support the integration of genetic testing into clinical decision-making for DAPT optimization.

Indexed as

Cytochrome P-450 CYP2C19Percutaneous Coronary InterventionPharmacogenomic TestingPharmacogenomic VariantsPlatelet Aggregation InhibitorsPurinergic P2Y Receptor AntagonistsClopidogrelGenotypeHemorrhageHumansRisk AssessmentRisk FactorsStentsTreatment OutcomeClopidogrelCYP2C19 protein, humanCytochrome P-450 CYP2C19Platelet Aggregation InhibitorsPurinergic P2Y Receptor AntagonistsAntiplatelet therapyGenetic testingPercutaneous coronary intervention

Identifiers

PMID40788330

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.