Tailored P2Y12 inhibitor treatment in patients undergoing non-urgent PCI—the POPular Risk Score study

Autor: Janssen, Paul W.A., Bergmeijer, Thomas O., Vos, Gert Jan A., Kelder, Johannes C., Qaderdan, Khalid, Godschalk, Thea C., Breet, Nicoline J., Deneer, Vera H.M., Hackeng, Christian M., ten Berg, Jurriën M., Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology
Přispěvatelé: Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Risk
medicine.medical_specialty
Prasugrel
Genotype
Platelet Function Tests
medicine.medical_treatment
P2Y inhibitor
030226 pharmacology & pharmacy
Clopidogrel/adverse effects
Percutaneous coronary intervention
03 medical and health sciences
0302 clinical medicine
Internal medicine
Hemorrhage/chemically induced
medicine
Journal Article
Humans
Platelet aggregation
Pharmacology (medical)
cardiovascular diseases
030212 general & internal medicine
CYP2C19
Prospective cohort study
Stroke/prevention & control
Aged
Pharmacology
Framingham Risk Score
business.industry
Thrombosis/prevention & control
General Medicine
Middle Aged
Clopidogrel
Prasugrel Hydrochloride/adverse effects
Cohort
Conventional PCI
Purinergic P2Y Receptor Antagonists/adverse effects
Myocardial Infarction/prevention & control
Female
business
Cytochrome P-450 CYP2C19/genetics
TIMI
medicine.drug
Zdroj: European Journal of Clinical Pharmacology, 75(9), 1201. Springer
European Journal of Clinical Pharmacology, 75(9), 1201. Springer Verlag
ISSN: 0031-6970
Popis: PURPOSE: The POPular Risk Score was developed for the selective intensification of P2Y 12 inhibitor treatment with prasugrel instead of clopidogrel in patients undergoing non-urgent percutaneous coronary intervention (PCI) with stent implantation. This score is based on platelet reactivity (VerifyNow P2Y 12 assay), CYP2C19 genotyping, and clinical risk factors. Our aim was to determine if the use of this score in clinical practice is associated with a reduction in thrombotic events without increasing bleeding events. METHODS: In a single-center prospective cohort study, patients with a high risk score were treated with prasugrel and patients with a low risk score with clopidogrel. The risk score-guided cohort was compared with a historic cohort of clopidogrel-treated patients. The endpoint consisted of all-cause death, myocardial infarction, stroke, or stent thrombosis during 1 year of follow-up. TIMI major and minor bleeding events were also analyzed. RESULTS: The guided cohort contained 1127 patients, 26.9% of whom were switched to prasugrel according to the POPular Risk Score. The historic cohort contained 893 patients. The incidence of the combined thrombotic endpoint was significantly lower in the guided cohort as compared with the historic cohort (8.4% versus 3.7%, p
Databáze: OpenAIRE
Externí odkaz: