Prasugrel Versus Ticagrelor in Patients With CYP2C19 Loss-of-Function Genotypes
Francesco Franchi, Fabiana Rollini, José Rivas, Andrea Rivas, Malhar Agarwal, Maryuri Briceno, Mustafa Wali, Ahmed Nawaz, Gabriel Silva, Zubair Shaikh, Naji Maailiki, Latonya Been, Andrés M. Pineda, Siva Suryadevara, Daniel Soffer, Martin M. Zenni, Theodore A. Bass, Dominick J. Angiolillo
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]).