Real-World Implementation of a Genotype-Guided P2Y12 Inhibitor De-Escalation Strategy in Acute Coronary Syndrome Patients

Jaouad Azzahhafi*, Wout W A van den Broek, Dean R P P Chan Pin Yin, Niels M R van der Sangen, Shabiga Sivanesan, Salahodin Bofarid, Joyce Peper, Daniel M F Claassens, Paul W A Janssen, Ankie M Harmsze, Ronald J Walhout, Melvyn Tjon Joe Gin, Deborah M Nicastia, Jorina Langerveld, Georgios J Vlachojannis, Rutger J van Bommel, Yolande Appelman, Ron H N van Schaik, José P S Henriques, Wouter J KikkertJurriën M Ten Berg

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: CYP2C19 genotype–guided de-escalation from ticagrelor or prasugrel to clopidogrel may optimize the balance between ischemic and bleeding risk in patients with acute coronary syndrome (ACS). Objectives: This study sought to compare bleeding and ischemic event rates in genotyped patients vs standard care. Methods: Since 2015, ACS patients in the multicenter FORCE-ACS (Future Optimal Research and Care Evaluation in Patients with Acute Coronary Syndrome) registry received standard dual antiplatelet therapy (DAPT). Since 2021, genotype-guided P2Y 12 inhibitor de-escalation was recommended at a single center, switching noncarriers of the loss-of-function allele CYP2C19∗3 or CYP2C19∗2 from ticagrelor or prasugrel to clopidogrel, whereas loss-of-function carriers remained on ticagrelor or prasugrel. The primary ischemic endpoint, a composite of cardiovascular mortality, myocardial infarction, or stroke, and the primary bleeding endpoint, Bleeding Academic Research Consortium 2, 3, or 5 bleeding, were compared between a genotyped cohort and a cohort treated with standard DAPT after 1 year. Results: Among 5,321 enrolled ACS patients, 406 underwent genotyping compared with 4,915 nongenotyped ACS patients on standard DAPT. In the genotyped cohort, 65.3% (n = 265) were noncarriers, 88.7% (n = 235) of whom were switched to clopidogrel. The primary ischemic endpoint occurred in 5.2% (n = 21) of patients in the genotyped cohort compared to 6.9% (n = 337) in the standard care cohort (adjusted HR: 0.82; 95% CI: 0.53-1.28). The primary bleeding rate was significantly lower in the genotyped cohort compared to the standard care cohort (4.7% vs 9.8%; adjusted HR: 0.47; 95% CI: 0.30-0.76). Conclusions: The implementation of a CYP2C19 genotype–guided P2Y 12 inhibitor de-escalation strategy in a real-world ACS population resulted in lower bleeding rates without an increase in ischemic events compared to a standard DAPT regimen.

Original languageEnglish
Pages (from-to)1996-2007
Number of pages12
JournalJACC. Cardiovascular interventions
Volume17
Issue number17
DOIs
Publication statusPublished - 9 Sept 2024

Keywords

  • CYP2C19
  • acute coronary syndrome
  • dual antiplatelet therapy
  • genotype-guided therapy

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