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

Authors
Her, Ae-YoungJeong, Young-HoonKim, Byeong-KeukJoo, Hyung JoonChang, KiyukPark, YongwhiSong, Young BinAhn, Sung GyunSuh, Jung-WonLee, Sang YeupCho, Jung RaeKim, Hyo-SooKim, Moo HyunLim, Do-SunShin, Eun-Seok
Issue Date
5월-2022
Publisher
YONSEI UNIV COLL MEDICINE
Keywords
East Asia; platelet function; genotype; drug-eluting stent; coronary artery disease
Citation
YONSEI MEDICAL JOURNAL, v.63, no.5, pp.413 - 421
Indexed
SCIE
SCOPUS
KCI
Journal Title
YONSEI MEDICAL JOURNAL
Volume
63
Number
5
Start Page
413
End Page
421
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/143081
DOI
10.3349/ymj.2022.63.5.413
ISSN
0513-5796
Abstract
Purpose: 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. Materials and Methods: 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. Results: 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 PTRGGenotype 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. Conclusion: 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. Trial Registration: ClinicalTrials.gov Identifier: NCT04734028.
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