Platelet Function and Genotype after DES Implantation in East Asian Patients: Rationale and Characteristics of the PTRG-DES Consortium

• Published in: Yonsei medical journal Vol. 63; no. 5; pp. 413 - 421
• Main 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
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.05.2022; 연세대학교의과대학
• Subjects: Clinical Studies as Topic; Clopidogrel - therapeutic use; Coronary Artery Disease - drug therapy; Coronary Artery Disease - genetics; Coronary Artery Disease - surgery; Cytochrome P-450 CYP2C19 - genetics; Drug-Eluting Stents; Genotype; Humans; Original; Platelet Function Tests; 의학일반; coronary artery disease; East Asia; drug-eluting stent; platelet function; genotype
• ISSN: 0513-5796; 1976-2437
• DOI: 10.3349/ymj.2022.63.5.413

Platelet function test (PFT) results and genotype hold unique prognostic implications in East Asian patients. The aim of the PTRG-DES (Platelet function and genoType-Related long-term proGnosis in Drug-Eluting Stent-treated Patients with coronary artery disease) consortium is to assess the clinical impact thereof on long-term clinical outcomes in Korean patients with coronary artery disease during dual antiplatelet therapy (DAPT) including clopidogrel. Searching publications on the PubMed, we reviewed clopidogrel treatment studies with PFT and/or genotype 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. Nine registries from 32 academic centers participated in the PTRG-DES consortium, contributing individual patient data from 13160 patients who underwent DES implantation between July 2003 and August 2018. The PTRG-PFT cohort was composed of 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 PTRG-Genotype cohort consisted of 8163 patients with candidate genotypes related with clopidogrel responsiveness. Of those with cytochrome P450 (CYP) 2C19 genotype, frequencies of carrying one and two loss-of-function allele (s) ( 2 or 3) were 47.9% (intermediate metabolizers) and 14.2% (poor metabolizers), respectively. The PTRG-DES consortium highlights unique values for on-clopidogrel platelet reactivity and CYP2C19 phenotype that may be important to developing optimal antiplatelet regimens in East Asian patients. ClinicalTrials.gov Identifier: NCT04734028.