News | Antiplatelet and Anticoagulation Therapies | August 18, 2016

Antiplatelet Agent Genetic Testing TAILOR-PCI Study Receives $7 Million NHLBI Grant

Study begun in 2013 assessing whether prescribing antiplatelet medication based on genotype will help prevent heart attack, stroke, unstable angina and cardiovascular death in PCI patients

TAILOR-PCI study, antiplatelet medication, genotype, NHLBI grant

August 18, 2016 — Researchers at the Peter Munk Cardiac Centre, Toronto, and at Mayo Clinic are leading the Tailored Antiplatelet Therapy to Lessen Outcomes after Percutaneous Coronary Intervention (TAILOR-PCI) study. This study has received $7 million in additional funding from the National Heart, Lung and Blood Institute (NHLBI) of the National Institutes of Health (NIH). When it began in 2013, TAILOR-PCI included study teams at 15 hospitals from Canada, the United States and South Korea, with a goal of enrolling 5,270 patients. Now, some 29 medical centers are participating, with more expected. The study involves the randomized comparison of clopidogrel bisulfate (Plavix) and ticagrelor (Brilinta), based on genetic testing that identifies resistance to ticagrelor in patients undergoing coronary balloon angioplasty.

The study is examining whether prescribing heart medication based on a patient’s CYP2C19 genotype will help prevent heart attack, stroke, unstable angina and cardiovascular death in patients who undergo percutaneous coronary intervention (PCI). A PCI, commonly known as an angioplasty, is a non-surgical procedure that opens up narrowed or blocked blood vessels in the heart.

“The significance and potential far-reaching impact of a clinical trial of this scope will push the boundaries about the benefits that personalized medicine for patients who undergo a coronary stent procedure can provide,” said Barry Rubin, M.D., medical director, Peter Munk Cardiac Centre, University Health Network (UHN). “The validation provided by the NHLBI through this important grant is further evidence of our leadership role in large-scale cardiovascular studies requiring international clinical trials expertise and a multi-disciplinary team approach,” he said. “This is the largest trial to evaluate a personalized molecular medicine approach to patients with heart disease that has even been carried out.”

The study was launched by Mayo Clinic Center for Individualized Medicine and the Department of Cardiovascular Diseases at Mayo Clinic, in collaboration with the Peter Munk Cardiac Centre, the Applied Health Research Centre at the University of Toronto and Spartan Bioscience, Ottawa.

“This is a multinational collaboration designed to inform clinical practice, in its truest sense,” said Michael Farkouh, M.D., cardiologist, chair, Peter Munk Centre of Excellence in Multinational Clinical Trials and one of two principal investigators of TAILOR-PCl. The other principal investigator is Naveen Pereira, M.D., cardiologist at the Mayo Clinic. “We are delighted to partner with the Mayo Clinic in this effort,” said Farkouh.

“NHLBI is happy to support this important study, which we hope will contribute to the evidence needed to start delivering precision medicine in clinical settings,” said Yves Rosenberg, M.D,. NHLBI program officer for the study, and chief of the Atherothrombosis and Coronary Artery Disease Branch. “This trial could have global impact by potentially changing treatment recommendations for millions of individuals with coronary artery disease needing antiplatelet treatment after a percutaneous coronary intervention.”

Antiplatelet medication has been shown to reduce the risk of heart attack, unstable angina, stroke and cardiovascular death after stent placement by reducing the possibility of blood clots around the site of the surgical incision. The current standard of care after angioplasty is to prescribe clopidogrel for one year.

“Today, we do this regardless of a person’s individual genotype, even though we have known for several years that variation in the CYP2C19 gene may diminish the benefit from the drug,” said Pereira. “What we don’t know — and why there is such confusion in the cardiovascular community — is whether these genetic differences affect long-term clinical outcomes.”

Read the article “Questions Remain on DAPT Prolongation”

For more information: www.petermunkcardiaccentre.ca

Related Content

electronic health records, EHR, warfarin therapy management, University of Missouri Health Care, blood thinner
News | Antiplatelet and Anticoagulation Therapies| January 17, 2017
Warfarin is a commonly prescribed blood thinner used to prevent harmful blood clots. However, the drug requires...
ICDs, implantable cardioverter defibrillators, survival rate, elderly patients, JACC study
News | Implantable Cardioverter Defibrillators (ICD)| January 17, 2017
Of patients over age 65 who received an implantable cardioverter-defibrillator (ICD) after surviving sudden cardiac...
University of Utah, Frank Sachse, heart failure, LVAD implantation, left ventricular assist device, biomarker, t-system

Two patients may seem equally sick based upon clinical measures, but differences in their heart physiology could predict who has the potential to recover from heart failure. A study carried out by scientists at the University of Utah finds that patients whose hearts have flattened t-tubules have a decreased chance of showing signs of recovery after implanting a mechanical heart pump. Ordinarily, t-tubules in the heart are long, thin, and rounded. Image courtesy of Frank Sachse.

News | Cardiac Diagnostics| January 17, 2017
Investigators at the University of Utah have identified distinct differences in the hearts of advanced heart failure...
Synergy stent, abluminal polymer DES, bioresorbable polymer DES, bioresorbable polymer metallic stent

The Synergy stent is the first FDA cleared drug-eluting stent to use a bioresorbable polymer drug carrier. When the polymer dissolves after about four months, the devices become a bare metal stent. The technology is supposed to reduce the rate of late stent thrombosis due to vessel inflammation caused by durable polymers.

Feature | Stents Bioresorbable| January 17, 2017 | Dave Fornell
One of the big advancements in drug-eluting stent (DES) technology has been the development of bioresorbable polymers
St. Jude Medical, Amplatzer Amulet LAA Occluder, observational study, TCT 2016
News | Left Atrial Appendage (LAA) Occluders| November 03, 2016
St. Jude Medical Inc. presented favorable results from the largest observational study to date of the company’s...
Medtronic, CoreValve Evolut R TAVR system, U.S. IDE Study, TCT 2016
News | Heart Valve Technology| November 03, 2016
Medtronic plc unveiled new clinical data showing that patients treated with the self-expanding CoreValve Evolut R...
congenital heart patients, cardiac cath lab, anesthesia sedation practices, joint document, SCAI, SPA, CCAS
News | Congenital Heart| November 03, 2016
The Society for Cardiovascular Angiography and Interventions (SCAI), the Society for Pediatric Anesthesia (SPA) and the...
open-heart surgery, PCI, percutaneous coronary intervention, NOBLE trial, left main coronary artery disease, LMCAD, TCT 2016
News | Cardiovascular Surgery| November 03, 2016
Coronary artery bypass (CABG) surgery is the standard treatment for revascularization in patients with left main...
SENTINEL trial, transcatheter embolic protection, TCEP, TAVR, stroke, TCT 2016
News | Embolic Protection Devices| November 03, 2016
An international study has found that transcatheter cerebral embolic protection (TCEP) is safe, provides effective...
News | Drug-Eluting Balloons| November 03, 2016
The Spectranetics Corp. announced that it has submitted to the U.S. Food & Drug Administration (FDA) its Pre-Market...
Overlay Init