Prasugrel Versus Ticagrelor in Patients With CYP2C19 Loss-of-Function Genotypes: Results of a Randomized Pharmacodynamic Study in a Feasibility Investigation of Rapid Genetic Testing.

CYP2C19 功能丧失基因型患者的普拉格雷与替格瑞洛的比较 ： 快速基因检测可行性调查中随机药效学研究的结果。

• 影响指数: 9.531
• 发表时间: May 2020
• 来源期刊: JACC Basic Transl Sci
• DOI: 10.1016/j.jacbts.2020.02.009
• PMID: 32478205
• 文章类型: Journal Article
• 作者列表: Franchi F,Rollini F,Rivas J,Rivas A,Agarwal M,Briceno M,Wali M,Nawaz A,Silva G,Shaikh Z,Maailiki N,Been L,Pineda AM,Suryadevara S,Soffer D,Zenni MM,Bass TA,Angiolillo DJ

关键词: ACS, acute coronary syndrome; CI, confidence interval; CYP, cytochrome P450; DAPT, dual antiplatelet therapy; HPR, high on-treatment platelet reactivity; LOF, loss of function; PCI, percutaneous coronary intervention; PD, pharmacodynamic; PRU, P2Y12 reaction unit; genotyping; percutaneous coronary intervention; pharmacodynamics; prasugrel; ticagrelor

Abstract

The feasibility of rapid genetic testing in patients undergoing percutaneous coronary intervention (PCI) and the comparison of the pharmacodynamic effects of prasugrel versus ticagrelor among carriers of cytochrome P450 2C19 loss-of-function alleles treated with PCI has been poorly explored. Rapid genetic testing using the Spartan assay was shown to be feasible and provides results in a timely fashion in a real-world setting of patients undergoing coronary angiography (n = 781). Among patients (n = 223, 28.5%), carriers of at least 1 loss-of-function allele treated with PCI (n = 65), prasugrel, and ticagrelor achieve similar levels of platelet inhibition. (A Pharmacodynamic Study Comparing Prasugrel Versus Ticagrelor in Patients Undergoing PCI With CYP2C19 Loss-of-function [NCT02065479]).

摘要

在接受经皮冠状动脉介入治疗（PCI）的患者中进行快速基因检测的可行性以及在接受PCI治疗的细胞色素P4502C19功能丧失等位基因携带者中普拉格雷与替格瑞洛的药效学效应的比较研究甚少。使用Spartan测定法进行快速遗传测试被证明是可行的，并且在接受冠状动脉造影的患者的现实环境中及时提供结果（n=781）。在患者中（n=223，28.5％），接受PCI治疗的至少1个功能丧失等位基因的携带者（n=65），普拉格雷,和替格瑞洛达到相似的血小板抑制水平。(一项比较普拉格雷与替格瑞洛在接受PCI并有CYP2C19功能丧失的患者中的药效学研究[NCT02065479])。