ABSTRACT NUMBER: ESOC2026YS211 PLATELET FUNCTION TESTING GUIDED ANTIPLATELET THERAPY IN PATIENTS WITH ISCHEMIC CARDIOVASCULAR AND CEREBROVASCULAR DISEASES:A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract Background and aims Whether platelet function testing (PFT) guided antiplatelet therapy improves outcomes in patients with ischemic cardiovascular and cerebrovascular diseases is unclear. We conducted a systematic review and meta-analysis to assess the safety and efficacy of PFT guided approach versus standard antiplatelet therapy. Methods We searched PubMed, Embase databases for any randomized controlled trials (RCTs) and cohort studies published in any language that compared PFT guided with standard therapy in patients with ischemic cardiovascular and cerebrovascular diseases. The primary efficacy outcome was major adverse cardiovascular and cerebrovascular events (MACCE), and the secondary efficacy outcomes were myocardial infarction (MI), stroke. The primary safety outcome was any bleeding events. The results were presented as odd ratio (OR) with 95% confidence interval (CI) and were pooled using a random-effects model. Results Our analysis included 9 RCTs and 6 cohort studies with a total of 13,647 patients. In all included studies, PFT guided antiplatelet therapy reduced MACCE (OR = 0.55, 95% CI 0.39–0.78, p = 0.001) compared with standard therapy, and without increasing the risk of bleeding events (OR = 0.82, 95% CI 0.64–1.07, p = 0.141). And PFT guided antiplatelet therapy also reduced the recurrence of MI (OR: 0.62, 95% CI: 0.42–0.91, P = 0.015). However, it did not significantly reduce the incidence of stroke (OR: 0.71, 95% CI: 0.50–1.02, P = 0.061). In summary, for patients with ischemic cardiovascular and cerebrovascular diseases, PFT guided antiplatelet therapy provides a net clinical benefit by reducing adverse cardiovascular events without increasing bleeding risk. Conflict of interest The authors declare that they have no competing interests.