• Yonsei medical journal · May 2022

    Review

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

    • Ae-Young Her, Young-Hoon Jeong, Byeong-Keuk Kim, Hyung Joon Joo, Kiyuk Chang, Yongwhi Park, Young Bin Song, Sung Gyun Ahn, Jung-Won Suh, Sang Yeup Lee, Jung Rae Cho, Hyo-Soo Kim, KimMoo HyunMHhttps://orcid.org/0000-0003-3468-6453Department of Cardiology, Dong-A University Hospital, Busan, Korea., Do-Sun Lim, Eun-Seok Shin, and PTRG-DES Consortium Investigators.
    • Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
    • Yonsei Med. J. 2022 May 1; 63 (5): 413-421.

    PurposePlatelet 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 MethodsSearching 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.ResultsNine 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.ConclusionThe 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 RegistrationClinicalTrials.gov Identifier: NCT04734028.© Copyright: Yonsei University College of Medicine 2022.

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