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Genetic testing non-inferior to standard drug treatment with regard to thrombotic events


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Conference
ESC 2019
Early CYP2C19 genetic testing to guide the selection of oral P2Y12 inhibitor therapy in patients undergoing percutaneous coronary intervention (PCI) has been shown to be non-inferior to standard treatment with ticagrelor or prasugrel at 12 months regarding thrombotic events. Importantly, the CYP2C19 genotype-guided approach also resulted in a lower incidence of bleeding. Claassens and colleagued enrolled 2,488 patients who underwent primary PCI with stent implantation, who were randomised to either a genotype-guided approach (n=1,242) or standard treatment (n=1,246) for the duration of 12 months. The two primary outcomes were net adverse clinical events (i.e, death from any cause, myocardial infarction, definite stent thrombosis, stroke, or major bleeding) at 12 months and major or minor bleeding at 12 months. Patients who were carriers of the CYP2C192 or CYP2C193 loss-of-function alleles in the genotype-guided group received tic...


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