Virtual ACC 2020 | TAILOR-PCI: Gene-Based Prescribing of Clopidogrel Does Not Change Outcomes

This very interesting work leaves us with a sour taste in our mouth, as it failed to meet its primary endpoint. Using genotype to individualize treatment with a P2Y12 inhibitor in patients with acute coronary syndrome or stable patients after a scheduled angioplasty compared with conventional treatment with clopidogrel does not reduce the risk of ischemic events at 12 months. This is another nice theory that crashes and burns against reality.

TAILOR PCR | Clopidogrel

Many people expected this work to provide a definitive answer on the efficacy of knowing patient genotype, after the publication of POPular Genetics a few months back showing the noninferiority of a genotype-guided strategy vs. treatment with ticagrelor or prasugrel, but without such information.

At 1 year, there was a 34% reduction in the combined endpoint (cardiovascular death, infarction, stroke, definite or probable stent thrombosis, and severe recurrent ischemia) with a strategy guided by genotype (basically, the identification of a CYP2C19 loss-of-function allele) compared with a conventional strategy with clopidogrel (4.0% vs. 5.9%; hazard ratio [HR]: 0.66; 95% confidence interval [CI]: 0.43-1.02). Such 34% is not statistically significant, since the target was 50%.

Original title: TAILOR PCI: tailored antiplatelet initiation to lessen outcomes due to decreased clopidogrel response after percutaneous coronary intervention.

Reference: Pereira N et al. Presentado en forma virtual en el ACC 2020.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

ACC 2025 | API-CAT: Reduced vs. Full Dose Extended Anticoagulation in Patients with Cancer Related VTE

The risk of cancer related recurrent venous thromboembolism (VTE) will drop over time, while bleeding risk will persist. At present, it is recommended we...

STRIDE: Semaglutide in Patients with Peripheral Arterial Disease and Type II Diabetes

Peripheral arterial disease (PAD) is a severe complication in patients with type II diabetes, primarily affecting peripheral vessels, especially below-the-knee (BTK) arteries. This condition...

TAVR and Anticoagulation: What Should We Do?

Transcatheter aortic valve replacement (TAVR) has consolidated as a valid strategy for certain groups of patients. However, approximately one third of those who require...

Direct Oral Anticoagulants for Ventricular Thrombus After STEMI

While the incidence of intracavitary thrombi after acute myocardial infarction (AMI) has decreased thanks to optimized primary angioplasty times, some studies report rates of...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

ACC 2025 | FAME 3: FFR Guided PCI vs CABG 5 Year Outcomes.

Earlier studies comparing percutaneous coronary intervention (PCI) vs coronary artery bypass graft (CABG) have shown fewer events at long term for the surgical strategy.  However,...

ACC 2025 | API-CAT: Reduced vs. Full Dose Extended Anticoagulation in Patients with Cancer Related VTE

The risk of cancer related recurrent venous thromboembolism (VTE) will drop over time, while bleeding risk will persist. At present, it is recommended we...

STRIDE: Semaglutide in Patients with Peripheral Arterial Disease and Type II Diabetes

Peripheral arterial disease (PAD) is a severe complication in patients with type II diabetes, primarily affecting peripheral vessels, especially below-the-knee (BTK) arteries. This condition...