Evidence map›Paper›PMID 34670396›Full record

Trial reportCirculation. Genomic and precision medicine2021

Genotype-Guided P2Y

Vibhu Parcha, Brittain F Heindl, Peng Li, Rajat Kalra, Nita A Limdi, Naveen L Pereira, Garima Arora, Pankaj Arora

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Circulation. Genomic and precision medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06665919 (Randomized Controlled Trial for Evaluating CYP2C19 Allele Genotype-guided Clopidogrel Treatment Outcomes in Real-world Practice After the ePCI), which is not on this map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
1.4field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06665919 nacompletednot on this mapstarted 2023, after this paper: background citation

Randomized Controlled Trial for Evaluating CYP2C19 Allele Genotype-guided Clopidogrel Treatment Outcomes in Real-world Practice After the ePCI

TypeinterventionalSponsorVistamedi Ltd.Ran2023 to 2025Enrolled283ConditionsCoronary Artery Disease, Clopidogrel Resistance, Coronary Thrombosis, Adverse Cardiac EventsArmsCYP2C19 Genotype-Guided Clopidogrel Treatment, CYP2C19 Genotype Guided Antiplatelet Treatment Alternative to Clopidogrel, The Conventional Clopidogrel Treatment
3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Genetic-Guided Oral P2YJACC. Cardiovascular interventions · 2023
    Trial
  5. Article
  6. Circulation · 2024
    Review
  7. Article
  8. Review
  9. Pharmacogenetics of Antiplatelet Therapy.Annual review of pharmacology and toxicology · 2023
    Review
  10. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Vibhu ParchaDivision of Cardiovascular Disease (V.P., B.F.H., G.A., P.A.), University of Alabama at Birmingham. Cardiology Division, University of Minnesota, MN.ORCID 0000-0002-4993-8177
Brittain F HeindlDivision of Cardiovascular Disease (V.P., B.F.H., G.A., P.A.), University of Alabama at Birmingham. Cardiology Division, University of Minnesota, MN.ORCID 0000-0002-0961-3562
Peng LiSchool of Nursing (P.L.), University of Alabama at Birmingham.ORCID 0000-0002-9026-9999
Rajat KalraCardiology Division, University of Minnesota, MN (R.K.).ORCID 0000-0002-8982-0595
Nita A LimdiDepartment of Neurology (N.A.L.), University of Alabama at Birmingham.
Naveen L PereiraDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (N.L.P.).ORCID 0000-0003-3813-3469
Garima AroraDivision of Cardiovascular Disease (V.P., B.F.H., G.A., P.A.), University of Alabama at Birmingham. Cardiology Division, University of Minnesota, MN.
Pankaj AroraDivision of Cardiovascular Disease (V.P., B.F.H., G.A., P.A.), University of Alabama at Birmingham. Cardiology Division, University of Minnesota, MN.ORCID 0000-0003-2420-3550
University of Minnesota · USUniversity of Alabama at Birmingham · USMayo Clinic · US

Funding

TAILOR PCI: Transitioning a Genotype Based Randomized Clinical Trial to a Registry Using Digital SolutionsU01HL128606 · NHLBI · MAYO CLINIC ROCHESTER · PI FARKOUH, MICHAEL E, PEREIRA, NAVEEN LUKE · 2016 to 2019
$7.0M
Race, Natriuretic Peptides and Physiological PerturbationsK23HL146887 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI ARORA, PANKAJ · 2019 to 2023
$969k
NHLBI NIH HHS K23 HL146887NHLBI NIH HHS U01 HL128606
6 · The paper itself

Abstract

backgroundAmong patients receiving percutaneous coronary intervention (PCI), the role of a genotype-guided approach for antiplatelet therapy compared with usual care is unclear. We conducted a Bayesian analysis of the entire TAILOR-PCI (Tailored Antiplatelet Initiation to Lessen Outcomes Due to Decreased Clopidogrel Response After Percutaneous Coronary Intervention) randomized clinical trial population to evaluate the effect of the genotype-guided antiplatelet therapy post-PCI compared with the usual care on the risk of major adverse cardiovascular events (MACE).

methodsThe primary outcome for our study was the composite of MACE (myocardial infarction, stroke, and cardiovascular death). Secondary outcomes included cardiovascular death, stroke, myocardial infarction, stent thrombosis, and major/minor bleeding. Bayesian modeling was used to estimate the probability of clinical benefit of genotype-guided therapy using (1) noninformative priors (ie, analyzing the TAILOR-PCI trial) and (2) informative priors derived from the ADAPT, POPular Genetics, IAC-PCI, and PHARMCLO trials (ie, analyzing TAILOR-PCI trial in the context of prior evidence). Risk ratio (RR: ratio of cumulative outcome incidence between genotype-guided and conventional therapy group) and 95% credible interval (CrI) were estimated for the study outcomes, and probability estimates for RR <1 were computed.

resultsUsing noninformative priors, in TAILOR-PCI the RR for MACE was 0.78 (95% CrI, 0.55-1.07) in genotype-guided therapy after PCI, and the probability of RR <1 was 94%. Using noninformative priors, the probability of RR <1 for cardiovascular death (RR, 0.95 [95% CrI, 0.52-1.74]), stroke (RR, 0.68 [95% CrI, 0.44-1.06]), myocardial infarction (RR, 0.84 [95% CrI, 0.37-1.89]), stent thrombosis (RR, 0.75 [95% CrI, 0.37-1.45]), and major or minor bleeding (RR, 1.22 [95% CrI, 0.84-1.77]) were 57%, 96%, 67%, 81%, and 15%, respectively. Using informative priors, the posterior probability of RR <1 for MACE, from genotype-guided therapy, was 99% (RR, 0.69 [95% CrI, 0.57-0.84]). Using informative priors, the posterior probability of RR <1 for cardiovascular death (RR, 0.86 [95% CrI, 0.61-1.19]), stroke (RR, 0.69 [95% CrI, 0.48-0.99]), myocardial infarction (RR:0.56 [95% CrI, 0.40-0.78]), stent thrombosis (RR, 0.59 [95% CrI, 0.38-0.94]), and major or minor bleeding (RR, 0.84 [95% CrI, 0.70-0.99]) were 81%, 99%, 99%, 99%, and 99%, respectively.

conclusionsBayesian analysis of the TAILOR-PCI trial provides clinically meaningful data on the posterior probability of reducing MACE using genotype-guided P2Y

Indexed as

Percutaneous Coronary InterventionBayes TheoremClopidogrelGenotypeHumansPlatelet Aggregation InhibitorsClopidogrelPlatelet Aggregation Inhibitorsgenomicsgenotypemyocardial infarctionpercutaneous coronary interventionpharmacogeneticsstentthrombosis

Identifiers

PMID34670396
PMCPMC8692353
OpenAlexW3206295545

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.