To evaluate whether genotype-guided antiplatelet therapy reduces the rates of cardiovascular events and bleeding events in patients with acute coronary syndrome (ACS). We systematically searched Pubmed, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL) (searched in September 2018) for controlled studies evaluating genotype-guided antiplatelet therapy in ACS with percutaneous coronary intervention (PCI) or without PCI. The primary endpoint was a composite of death, myocardial infarction (MI), stroke, targeted vessel revascularization and/or major bleeding. A total of five studies involving 2900 patients were included. Compared with the conventional group, the genotype-guided group had a decreased risk of primary composite outcomes (RR= 0.54; 95% CI: 0.41-0.72; I2 = 30%), death (RR = 0.54; 95% CI: 0.32-0.94; I2 = 21%), MI (RR = 0.52; 95% CI: 0.31-0.88; I2 = 49%), targeted vessel revascularization (RR = 0.59; 95% CI: 0.35-0.98; I2 = 0%), but not for stroke (RR = 0.53; 95% CI: 0.22-1.24; I2 = 0%) and bleeding events (RR = 0.80; 95% CI: 0.51-1.25; I2 = 33%). Genotype-guided strategies could reduce the rates of cardiovascular events without increasing bleeding events compared with conventional treatment in ACS. Future multi-centre genotype-based randomized control trials are required to confirm these findings.

中文翻译：

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基因型引导的抗血小板治疗与急性冠状动脉综合征患者的常规治疗相比：系统评价和荟萃分析。

为了评估基因型引导的抗血小板治疗是否能降低急性冠脉综合征（ACS）患者的心血管事件和出血事件的发生率。我们系统地搜索了Pubmed，Embase和Cochrane对照试验中央登记册（CENTRAL）（于2018年9月检索），以评估经皮冠状动脉介入治疗（PCI）或无PCI的ACS中基因型指导的抗血小板治疗的对照研究。主要终点是死亡，心肌梗塞（MI），中风，靶向血管血运重建和/或大出血的复合物。总共包括5个研究，涉及2900名患者。与常规组相比，基因型指导组的主要复合终点风险（RR = 0.54； 95％CI：0.41-0.72； I2 = 30％），死亡（RR = 0.54； 95％CI：0.32-）降低。 0.94； I2 = 21％），MI（RR = 0.52; 95％CI：0.31-0.88; I2 = 49％），靶向血管血运重建（RR = 0.59; 95％CI：0.35-0.98; I2 = 0％），但非卒中（RR = 0.53） ； 95％CI：0.22-1.24； I2 = 0％）和出血事件（RR = 0.80； 95％CI：0.51-1.25； I2 = 33％）。与ACS的常规治疗相比，基因型指导的策略可以降低心血管事件的发生率，而不会增加出血事件。需要未来基于多中心基因型的随机对照试验来证实这些发现。与ACS的常规治疗相比，基因型指导的策略可以降低心血管事件的发生率，而不会增加出血事件。需要未来基于多中心基因型的随机对照试验来证实这些发现。与ACS的常规治疗相比，基因型指导的策略可以降低心血管事件的发生率，而不会增加出血事件。需要未来基于多中心基因型的随机对照试验来证实这些发现。