We use cookies to improve your experience. By continuing to browse this site, you accept our cookie policy.×
Skip main navigation
Aging Health
Bioelectronics in Medicine
Biomarkers in Medicine
Breast Cancer Management
CNS Oncology
Colorectal Cancer
Concussion
Epigenomics
Future Cardiology
Future Medicine AI
Future Microbiology
Future Neurology
Future Oncology
Future Rare Diseases
Future Virology
Hepatic Oncology
HIV Therapy
Immunotherapy
International Journal of Endocrine Oncology
International Journal of Hematologic Oncology
Journal of 3D Printing in Medicine
Lung Cancer Management
Melanoma Management
Nanomedicine
Neurodegenerative Disease Management
Pain Management
Pediatric Health
Personalized Medicine
Pharmacogenomics
Regenerative Medicine

Is there a benefit for CYP2C19 genotype-guided antiplatelet treatment in elderly acute coronary syndrome patients?

    Wout WA van den Broek

    Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands

    &
    Jurriën M ten Berg

    *Author for correspondence:

    E-mail Address: jurtenberg@gmail.com

    Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands

    Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands

    Published Online:https://doi.org/10.2217/pgs-2021-0078
    Free first page

    References

    • 1. Valgimigli M, Bueno H, Byrne RA et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS. Eur. J. Cardiothorac. Surg. 53(1), 34–78 (2017).
    • 2. Collet J-P, Thiele H, Barbato E et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur. Heart J. 42(14), 1289–1367 (2020).
    • 3. Wiviott SD, Braunwald E, McCabe CH et al. TRITON-TIMI 38: prasugrel versus clopidogrel in patients with acute coronary syndromes. N. Engl. J. Med. 357(20), 2001–15 (2007).
    • 4. Wallentin L, Becker RC, Budaj A et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N. Engl. J. Med. 361(11), 1045–57 (2009).
    • 5. Yeh RW, Secemsky EA, Kereiakes DJ et al. Development and validation of a prediction rule for benefit and harm of dual antiplatelet therapy beyond 1 year after percutaneous coronary intervention original investigation. JAMA 315(16), 1735–1749 (2016).
    • 6. Saar A, Marandi T, Ainla T, Fischer K, Blöndal M, Eha J. The risk-treatment paradox in non-ST-elevation myocardial infarction patients according to their estimated GRACE risk. Int. J. Cardiol. 272, 26–32(2018).
    • 7. Gimbel ME, Tavenier AH, Bor W et al. Ticagrelor versus clopidogrel in older patients with NSTE-ACS using oral anticoagulation: asub-analysis of the POPular age trial. J. Clin. Med. 9(10), 3249 (2020).
    • 8. Cayla G, Cuisset T, Silvain J et al. Platelet function monitoring to adjust antiplatelet therapy in elderly patients stented for an acute coronary syndrome (ANTARCTIC): an open-label, blinded-endpoint, randomised controlled superiority trial. Lancet 388(10055), 2015–2022 (2016).
    • 9. Sibbing D, Gross L, Trenk D et al. Age and outcomes following guided de-escalation of antiplatelet treatment in acute coronary syndrome patients undergoing percutaneous coronary intervention: results from the randomized TROPICAL-ACS trial. European Heart Journal 39(29),), 2749–2758 (2019).
    • 10. Claassens DMF, Vos GJA, Bergmeijer TO et al. A genotype-guided strategy for oral P2Y 12 inhibitors in primary PCI. N. Engl. J. Med. 381(17), 1621–1631 (2019).
    • 11. Claassens DMF, Gimbel ME, Bergmeijer TO et al. Clopidogrel in noncarriers of CYP2C19 loss-of-function alleles versus ticagrelor in elderly patients with acute coronary syndrome: a pre-specified sub analysis from the POPular Genetics and POPular age trials CYP2C19 alleles in elderly patients. Int. J. Cardiol. 334, 10–17 (2021).
    • 12. Husted S, James S, Becker RC et al. Ticagrelor versus clopidogrel in elderly patients with acute coronary syndromes: asubstudy from the prospective randomized PLATelet inhibition and patient outcomes (PLATO) trial. Circ. Cardiovasc. Qual. Outcomes 5(5), 680–688 (2012).
    • 13. Schmucker J, Fach A, Mata Marin LA et al. Efficacy and safety of ticagrelor in comparison to clopidogrel in elderly patients with ST-segment-elevation myocardial infarctions. J. Am. Heart Assoc. 8(18), e012530 (2019)
    • 14. Szummer K, Montez-Rath ME, Alfredsson J et al. Comparison between ticagrelor and clopidogrel in elderly patients with an acute coronary syndrome: insights from the SWEDEHEART registry. Circulation 142(18), 1700–8 (2020).
    • 15. Pereira NL, Rihal C, Lennon R et al. Effect of CYP2C19 genotype on ischemic outcomes during oral P2Y12 inhibitor therapy: ameta-analysis. JACC Cardiovasc. Interv. 14(7), 739–750 (2021).
    • 16. Angiolillo DJ, Capodanno D, Danchin N et al. Derivation, validation, and prognostic utility of a prediction rule for nonresponse to clopidogrel: the ABCD-GENE score. JACC Cardiovasc. Interv. 13(5), 606–617 (2020).