Platelet Function and Genotype after DES Implantation in East Asian Patients: Rationale and Characteristics of the PTRG-DES Consortiumopen access
- Authors
- Her, Ae-Young; Jeong, Young-Hoon; Kim, Byeong-Keuk; Joo, Hyung Joon; Chang, Kiyuk; Park, Yongwhi; Song, Young Bin; Ahn, Sung Gyun; Suh, Jung-Won; Lee, Sang Yeup; Cho, Jung Rae; Kim, Hyo-Soo; Kim, Moo Hyun; Lim, Do-Sun; Shin, Eun-Seok
- Issue Date
- May-2022
- Publisher
- 연세대학교의과대학
- Keywords
- East Asia; platelet function; genotype; drug-eluting stent; coronary artery disease
- Citation
- Yonsei Medical Journal, v.63, no.5, pp 413 - 421
- Pages
- 9
- Journal Title
- Yonsei Medical Journal
- Volume
- 63
- Number
- 5
- Start Page
- 413
- End Page
- 421
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/61393
- DOI
- 10.3349/ymj.2022.63.5.413
- ISSN
- 0513-5796
1976-2437
- Abstract
- Purpose: Platelet function test (PFT) results and genotype hold unique prognostic implications in East Asian patients. The aim ofthe PTRG-DES (Platelet function and genoType-Related long-term proGnosis in Drug-Eluting Stent-treated Patients with coronaryartery disease) consortium is to assess the clinical impact thereof on long-term clinical outcomes in Korean patients withcoronary artery disease during dual antiplatelet therapy (DAPT) including clopidogrel.Materials and Methods: Searching publications on the PubMed, we reviewed clopidogrel treatment studies with PFT and/orgenotype data for potential inclusion in this study. Lead investigators were invited to share PFT/genotype results, patient characteristics,and clinical outcomes to evaluate relationships among them.Results: Nine registries from 32 academic centers participated in the PTRG-DES consortium, contributing individual patient datafrom 13160 patients who underwent DES implantation between July 2003 and August 2018. The PTRG-PFT cohort was composedof 11714 patients with available VerifyNow assay results. Platelet reactivity levels reached 218±79 P2Y12 reaction units (PRU), and high on-clopidogrel platelet reactivity based on a consensus-recommended cutoff (PRU >208) was observed in 55.9%. The PTRGGenotypecohort consisted of 8163 patients with candidate genotypes related with clopidogrel responsiveness. Of those with cytochromeP450 (CYP) 2C19 genotype, frequencies of carrying one and two loss-of-function allele (s) (*2 or *3) were 47.9% (intermediatemetabolizers) and 14.2% (poor metabolizers), respectively.Conclusion: The PTRG-DES consortium highlights unique values for on-clopidogrel platelet reactivity and CYP2C19 phenotypethat may be important to developing optimal antiplatelet regimens in East Asian patients.Trial Registration: ClinicalTrials.gov Identifier: NCT04734028.
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