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September 3, 2019New England Journal of Medicine646 citationsOpen Access

A Genotype-Guided Strategy for Oral P2Y 12 Inhibitors in Primary PCI

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Why the study?

Does a CYP2C19 genotype-guided strategy for selection of oral P2Y12 inhibitor therapy reduce bleeding and prevent thrombotic events in patients undergoing primary PCI?

Population

Patients undergoing primary PCI

Comparison

CYP2C19 genotype-guided strategy for selection… vs Standard treatment with ticagrelor or prasugrel

Design

RCT

Follow-up

12 months

Authors

DCDaniel M.F. ClaassensGVGerrit J.A. VosTBThomas O. Bergmeijer

Discussion

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Overview

Supports CYP2C19-guided P2Y12 selection in primary PCI to reduce bleeding; extends RCT evidence for precision antiplatelet therapy.

Structured PICO

Does a CYP2C19 genotype-guided strategy for selection of oral P2Y12 inhibitor therapy reduce bleeding and prevent thrombotic events in patients undergoing primary PCI?

P
Population
Patients undergoing primary PCI
I
Intervention
CYP2C19 genotype-guided strategy for selection of oral P2Y12 inhibitor therapy
C
Comparator
Standard treatment with ticagrelor or prasugrel
O
Outcome
Thrombotic events at 12 monthshard clinical

A CYP2C19 genotype-guided strategy for P2Y12 inhibitor selection in primary PCI is noninferior for preventing thrombotic events while significantly reducing bleeding compared to standard therapy.

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Cite This Study

Claassens et al. (2019) studied this question.

synapsesocial.com/papers/69a30061efb2b0e59c0a3e62https://doi.org/10.1056/nejmoa1907096
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Clopidogrel Versus Ticagrelor or Prasugrel After Primary Percutaneous Coronary Intervention According to CYP2C19 Genotype2021 · 29 citations
  2. 2Optimizing selection of P2Y <sub>12</sub> inhibiting therapy: clopidogrel, prasugrel or ticagrelor2025 · 1 citations
  3. 3<i>CYP2C19</i> Genetic Testing for Oral P2Y12 Inhibitor Therapy: A Scientific Statement From the American Heart Association2024 · 116 citations
  4. 4Genotype-Guided P2Y <sub>12</sub> -Inhibitor De-Escalation Strategy in Acute Coronary Syndrome: Observational Evidence From the POPular-GUIDE PCI2026 · 2 citations
  5. 5Implementation and Evaluation of a <i>CYP2C19</i> Genotype-Guided Antiplatelet Therapy Algorithm in High-Risk Coronary Artery Disease Patients2015 · 39 citations