Login
- Document type:
- Journal Article; Article
- Author(s):
- Gross, Lisa; Trenk, Dietmar; Jacobshagen, Claudius; Krieg, Anne; Gawaz, Meinrad; Massberg, Steffen; Baylacher, Monika; Aradi, Daniel; Stimpfle, Fabian; Hromek, Julia; Vogelgesang, Anja; Hadamitzky, Martin; Sibbing, Dirk; Geisler, Tobias
- Title:
- Genotype-Phenotype Association and Impact on Outcomes following Guided De-Escalation of Anti-Platelet Treatment in Acute Coronary Syndrome Patients: The TROPICAL-ACS Genotyping Substudy.
- Abstract:
- Phenotype-guided de-escalation (PGDE) of P2Y-inhibitor treatment with an early switch from prasugrel to clopidogrel was identified as an effective alternative treatment strategy in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). The Testing Responsiveness to Platelet Inhibition on Chronic Antiplatelet Treatment for Acute Coronary Syndromes (TROPICAL-ACS) Genotyping Substudy aimed to investigate whether genotypes correlate with on-treatment platelet reactivity (PR) in ACS patients treated with clopidogrel or prasugrel and thus might be useful for guidance of early de-escalation of anti-platelet treatment. A total of 603 ACS consecutive patients were enrolled in four centres (23.1% of the overall TROPICAL-ACS population). Rapid genotyping (Spartan RX) for , and alleles was performed. Associations between PR and the primary and secondary endpoints of the TROPICAL-ACS trial and and carrier status were evaluated.For the PGDE group, the on-clopidogrel PR significantly differed across ( < 0.001) and genotypes ( = 0.05). Control group patients were not related ( = 0.90, = 0.74) to on-prasugrel PR. For high PR versus non-high PR patients within the PGDE group, significant differences were observed for the rate of allele carriers (43% vs. 28%, = 0.007). and carrier status correlates with PR in ACS patients treated with clopidogrel and thus might be useful for pre-selecting patients who will and who may not be suitable for PGDE of anti-platelet treatment. Regarding phenotype-guided treatment, we did not observe added benefit of genotyping to predict ischaemic and bleeding risk in patients who underwent a PGDE approach. URL: https//www.clinicaltrials.gov. Unique Identifier: NCT: 01959451.
- Journal title abbreviation:
- Thromb Haemost
- Year:
- 2018
- Journal volume:
- 118
- Journal issue:
- 9
- Pages contribution:
- 1656-1667
- Language:
- eng
- Fulltext / DOI:
- doi:10.1055/s-0038-1667337
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/30103241
- Print-ISSN:
- 0340-6245
- TUM Institution:
- Institut für Radiologie
BibTeX