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.

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

doi:10.1055/s-0038-1667337

Benutzer: Gast

journal article

Titel:: 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.
Dokumenttyp:: Journal Article; Article
Autor(en):: 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
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.
Zeitschriftentitel:: Thromb Haemost
Jahr:: 2018
Band / Volume:: 118
Heft / Issue:: 9
Seitenangaben Beitrag:: 1656-1667
Sprache:: eng
Volltext / DOI:: doi:10.1055/s-0038-1667337
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/30103241
Print-ISSN:: 0340-6245
TUM Einrichtung:: Institut für Radiologie
BibTeX

Vorkommen:

mediaTUM Gesamtbestand Hochschulbibliographie 2018 Fakultäten Medizin Institut für Radiologie

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Institut für Diagnostische und Interventionelle Radiologie (Prof. Makowski)Institut für Radiologie und Nuklearmedizin 2018