Contemporary use of platelet function and pharmacogenomic testing among patients with acute myocardial infarction undergoing percutaneous coronary intervention in the United States
Background Although platelet function and pharmacogenomic testing have been studied in clinical trials, their adoption into contemporary practice is unknown. Methods We studied patterns of platelet function and pharmacogenomic testing among 10,048 patients with acute myocardial infarction treated wi...
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| Veröffentlicht in: | The American heart journal 2015-10, Vol.170 (4), p.706-714 |
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| creator | Wang, Tracy Y., MD, MHS, MSc Henry, Timothy D., MD McCoy, Lisa A., MS Berger, Peter B., MD Cohen, David J., MD, MSc Effron, Mark B., MD Zettler, Marjorie, PhD, MPH Baker, Brian A., PharmD Messenger, John C., MD Peterson, Eric D., MD, MPH |
| description | Background Although platelet function and pharmacogenomic testing have been studied in clinical trials, their adoption into contemporary practice is unknown. Methods We studied patterns of platelet function and pharmacogenomic testing among 10,048 patients with acute myocardial infarction treated with percutaneous coronary intervention at 226 US hospitals in the TRANSLATE-ACS observational study between April 2010 and October 2012, excluding those receiving research protocol-mandated testing. Inverse probability–weighted propensity adjustment was used to compare 1-year bleeding and major adverse cardiac event risks between patients with and without testing. Results Overall, 337 (3.4%) patients underwent predischarge platelet function testing, whereas 85 (0.9%) underwent pharmacogenomic testing; 82% and 93% of hospitals never performed any platelet function or pharmacogenomic testing, respectively. Patients undergoing testing were more likely to be on an adenosine diphosphate receptor inhibitor preadmission or to have percutaneous coronary intervention of a previously treated lesion. Tested patients were more likely than nontested patients to be switched from clopidogrel to prasugrel/ticagrelor (25.7% vs 9.7%, P < .001) and were more likely to be on prasugrel/ticagrelor 6 months postdischarge (33.8% vs 25.1%, P < .001). No significant differences in 1-year bleeding and major adverse cardiac event risks were observed between tested and nontested patients (adjusted hazard ratios 1.06 [95% CI 0.68-1.65] and 1.21 [95% CI 0.94-1.54], respectively). Conclusions Platelet function and pharmacogenomic testing are rarely performed in contemporary myocardial infarction patients in the United States. When tested, patients were more likely to be treated with higher-potency adenosine diphosphate receptor inhibitors, yet no significant differences in longitudinal outcomes were observed. |
| doi_str_mv | 10.1016/j.ahj.2015.06.021 |
| format | Article |
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Methods We studied patterns of platelet function and pharmacogenomic testing among 10,048 patients with acute myocardial infarction treated with percutaneous coronary intervention at 226 US hospitals in the TRANSLATE-ACS observational study between April 2010 and October 2012, excluding those receiving research protocol-mandated testing. Inverse probability–weighted propensity adjustment was used to compare 1-year bleeding and major adverse cardiac event risks between patients with and without testing. Results Overall, 337 (3.4%) patients underwent predischarge platelet function testing, whereas 85 (0.9%) underwent pharmacogenomic testing; 82% and 93% of hospitals never performed any platelet function or pharmacogenomic testing, respectively. Patients undergoing testing were more likely to be on an adenosine diphosphate receptor inhibitor preadmission or to have percutaneous coronary intervention of a previously treated lesion. Tested patients were more likely than nontested patients to be switched from clopidogrel to prasugrel/ticagrelor (25.7% vs 9.7%, P < .001) and were more likely to be on prasugrel/ticagrelor 6 months postdischarge (33.8% vs 25.1%, P < .001). No significant differences in 1-year bleeding and major adverse cardiac event risks were observed between tested and nontested patients (adjusted hazard ratios 1.06 [95% CI 0.68-1.65] and 1.21 [95% CI 0.94-1.54], respectively). Conclusions Platelet function and pharmacogenomic testing are rarely performed in contemporary myocardial infarction patients in the United States. When tested, patients were more likely to be treated with higher-potency adenosine diphosphate receptor inhibitors, yet no significant differences in longitudinal outcomes were observed.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2015.06.021</identifier><identifier>PMID: 26386794</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute coronary syndromes ; Aged ; Blood platelets ; Blood Platelets - physiology ; Cardiovascular ; Clinical medicine ; Consent ; Coronary vessels ; Data collection ; Electrocardiography ; Female ; Follow-Up Studies ; Heart attacks ; Hospitalization ; Humans ; Male ; Medical records ; Middle Aged ; Myocardial Infarction - blood ; Myocardial Infarction - diagnosis ; Myocardial Infarction - therapy ; Percutaneous Coronary Intervention ; Pharmacogenetics - methods ; Platelet Activation - drug effects ; Platelet Aggregation Inhibitors - therapeutic use ; Platelet Function Tests ; Preoperative Period ; Prospective Studies ; Studies ; United States ; Veins & arteries</subject><ispartof>The American heart journal, 2015-10, Vol.170 (4), p.706-714</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Oct 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c421t-d50badf8789cf6c027ac45f2a84758ca57f7d6c658e44e1ec2a3ddf8126e3bdd3</citedby><cites>FETCH-LOGICAL-c421t-d50badf8789cf6c027ac45f2a84758ca57f7d6c658e44e1ec2a3ddf8126e3bdd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1712843941?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26386794$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Tracy Y., MD, MHS, MSc</creatorcontrib><creatorcontrib>Henry, Timothy D., MD</creatorcontrib><creatorcontrib>McCoy, Lisa A., MS</creatorcontrib><creatorcontrib>Berger, Peter B., MD</creatorcontrib><creatorcontrib>Cohen, David J., MD, MSc</creatorcontrib><creatorcontrib>Effron, Mark B., MD</creatorcontrib><creatorcontrib>Zettler, Marjorie, PhD, MPH</creatorcontrib><creatorcontrib>Baker, Brian A., PharmD</creatorcontrib><creatorcontrib>Messenger, John C., MD</creatorcontrib><creatorcontrib>Peterson, Eric D., MD, MPH</creatorcontrib><title>Contemporary use of platelet function and pharmacogenomic testing among patients with acute myocardial infarction undergoing percutaneous coronary intervention in the United States</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background Although platelet function and pharmacogenomic testing have been studied in clinical trials, their adoption into contemporary practice is unknown. Methods We studied patterns of platelet function and pharmacogenomic testing among 10,048 patients with acute myocardial infarction treated with percutaneous coronary intervention at 226 US hospitals in the TRANSLATE-ACS observational study between April 2010 and October 2012, excluding those receiving research protocol-mandated testing. Inverse probability–weighted propensity adjustment was used to compare 1-year bleeding and major adverse cardiac event risks between patients with and without testing. Results Overall, 337 (3.4%) patients underwent predischarge platelet function testing, whereas 85 (0.9%) underwent pharmacogenomic testing; 82% and 93% of hospitals never performed any platelet function or pharmacogenomic testing, respectively. Patients undergoing testing were more likely to be on an adenosine diphosphate receptor inhibitor preadmission or to have percutaneous coronary intervention of a previously treated lesion. Tested patients were more likely than nontested patients to be switched from clopidogrel to prasugrel/ticagrelor (25.7% vs 9.7%, P < .001) and were more likely to be on prasugrel/ticagrelor 6 months postdischarge (33.8% vs 25.1%, P < .001). No significant differences in 1-year bleeding and major adverse cardiac event risks were observed between tested and nontested patients (adjusted hazard ratios 1.06 [95% CI 0.68-1.65] and 1.21 [95% CI 0.94-1.54], respectively). Conclusions Platelet function and pharmacogenomic testing are rarely performed in contemporary myocardial infarction patients in the United States. When tested, patients were more likely to be treated with higher-potency adenosine diphosphate receptor inhibitors, yet no significant differences in longitudinal outcomes were observed.</description><subject>Acute coronary syndromes</subject><subject>Aged</subject><subject>Blood platelets</subject><subject>Blood Platelets - physiology</subject><subject>Cardiovascular</subject><subject>Clinical medicine</subject><subject>Consent</subject><subject>Coronary vessels</subject><subject>Data collection</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart attacks</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Male</subject><subject>Medical records</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - blood</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - therapy</subject><subject>Percutaneous Coronary Intervention</subject><subject>Pharmacogenetics - methods</subject><subject>Platelet Activation - drug effects</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Platelet Function Tests</subject><subject>Preoperative Period</subject><subject>Prospective Studies</subject><subject>Studies</subject><subject>United States</subject><subject>Veins & arteries</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kk-L1TAUxYMoznP0A7iRgBs3rUmapi2CMDz8BwMuxlmHvOT2vdQ2qUk68r6XH9CUjgqzcJMQ-J3DuTkXoZeUlJRQ8XYo1WkoGaF1SURJGH2EdpR0TSEazh-jHSGEFW1Dqgv0LMYhPwVrxVN0wUTViqbjO_Rr712CafZBhTNeImDf43lUCUZIuF-cTtY7rJzB80mFSWl_BOcnq3GCmKw7YjX5fM4qWXAp4p82nbDSSwI8nb1WwVg1Yut6FTavxRkIR79KZwgZVA78ErH2wbs1hc2Jwl02W2nrcDoBvnU2gcE3KSeLz9GTXo0RXtzfl-j244dv-8_F9ddPX_ZX14XmjKbC1OSgTN82bad7oQlrlOZ1z1TLm7rVqm76xggt6hY4BwqaqcpknjIB1cGY6hK92Xzn4H8seVw52ahhHLfEkja0FoJ0pM3o6wfo4JfgcrqVYi2vOk4zRTdKBx9jgF7OwU55ZkmJXCuVg8yVyrVSSYTMlWbNq3vn5TCB-av402EG3m0A5K-4sxBk1LkKDcYG0Ekab_9r__6BWo_WWa3G73CG-G8KGZkk8mbdqXWlaE1I1dWi-g2c8Mxi</recordid><startdate>20151001</startdate><enddate>20151001</enddate><creator>Wang, Tracy Y., MD, MHS, MSc</creator><creator>Henry, Timothy D., MD</creator><creator>McCoy, Lisa A., MS</creator><creator>Berger, Peter B., MD</creator><creator>Cohen, David J., MD, MSc</creator><creator>Effron, Mark B., MD</creator><creator>Zettler, Marjorie, PhD, MPH</creator><creator>Baker, Brian A., PharmD</creator><creator>Messenger, John C., MD</creator><creator>Peterson, Eric D., MD, MPH</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20151001</creationdate><title>Contemporary use of platelet function and pharmacogenomic testing among patients with acute myocardial infarction undergoing percutaneous coronary intervention in the United States</title><author>Wang, Tracy Y., MD, MHS, MSc ; Henry, Timothy D., MD ; McCoy, Lisa A., MS ; Berger, Peter B., MD ; Cohen, David J., MD, MSc ; Effron, Mark B., MD ; Zettler, Marjorie, PhD, MPH ; Baker, Brian A., PharmD ; Messenger, John C., MD ; Peterson, Eric D., MD, MPH</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c421t-d50badf8789cf6c027ac45f2a84758ca57f7d6c658e44e1ec2a3ddf8126e3bdd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Acute coronary syndromes</topic><topic>Aged</topic><topic>Blood platelets</topic><topic>Blood Platelets - physiology</topic><topic>Cardiovascular</topic><topic>Clinical medicine</topic><topic>Consent</topic><topic>Coronary vessels</topic><topic>Data collection</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart attacks</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Male</topic><topic>Medical records</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - blood</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Myocardial Infarction - therapy</topic><topic>Percutaneous Coronary Intervention</topic><topic>Pharmacogenetics - methods</topic><topic>Platelet Activation - drug effects</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>Platelet Function Tests</topic><topic>Preoperative Period</topic><topic>Prospective Studies</topic><topic>Studies</topic><topic>United States</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Tracy Y., MD, MHS, MSc</creatorcontrib><creatorcontrib>Henry, Timothy D., MD</creatorcontrib><creatorcontrib>McCoy, Lisa A., MS</creatorcontrib><creatorcontrib>Berger, Peter B., MD</creatorcontrib><creatorcontrib>Cohen, David J., MD, MSc</creatorcontrib><creatorcontrib>Effron, Mark B., MD</creatorcontrib><creatorcontrib>Zettler, Marjorie, PhD, MPH</creatorcontrib><creatorcontrib>Baker, Brian A., PharmD</creatorcontrib><creatorcontrib>Messenger, John C., MD</creatorcontrib><creatorcontrib>Peterson, Eric D., MD, MPH</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Physical Education Index</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database (Proquest)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database (Proquest)</collection><collection>Medical Database</collection><collection>ProQuest_Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Tracy Y., MD, MHS, MSc</au><au>Henry, Timothy D., MD</au><au>McCoy, Lisa A., MS</au><au>Berger, Peter B., MD</au><au>Cohen, David J., MD, MSc</au><au>Effron, Mark B., MD</au><au>Zettler, Marjorie, PhD, MPH</au><au>Baker, Brian A., PharmD</au><au>Messenger, John C., MD</au><au>Peterson, Eric D., MD, MPH</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Contemporary use of platelet function and pharmacogenomic testing among patients with acute myocardial infarction undergoing percutaneous coronary intervention in the United States</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2015-10-01</date><risdate>2015</risdate><volume>170</volume><issue>4</issue><spage>706</spage><epage>714</epage><pages>706-714</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Background Although platelet function and pharmacogenomic testing have been studied in clinical trials, their adoption into contemporary practice is unknown. Methods We studied patterns of platelet function and pharmacogenomic testing among 10,048 patients with acute myocardial infarction treated with percutaneous coronary intervention at 226 US hospitals in the TRANSLATE-ACS observational study between April 2010 and October 2012, excluding those receiving research protocol-mandated testing. Inverse probability–weighted propensity adjustment was used to compare 1-year bleeding and major adverse cardiac event risks between patients with and without testing. Results Overall, 337 (3.4%) patients underwent predischarge platelet function testing, whereas 85 (0.9%) underwent pharmacogenomic testing; 82% and 93% of hospitals never performed any platelet function or pharmacogenomic testing, respectively. Patients undergoing testing were more likely to be on an adenosine diphosphate receptor inhibitor preadmission or to have percutaneous coronary intervention of a previously treated lesion. Tested patients were more likely than nontested patients to be switched from clopidogrel to prasugrel/ticagrelor (25.7% vs 9.7%, P < .001) and were more likely to be on prasugrel/ticagrelor 6 months postdischarge (33.8% vs 25.1%, P < .001). No significant differences in 1-year bleeding and major adverse cardiac event risks were observed between tested and nontested patients (adjusted hazard ratios 1.06 [95% CI 0.68-1.65] and 1.21 [95% CI 0.94-1.54], respectively). Conclusions Platelet function and pharmacogenomic testing are rarely performed in contemporary myocardial infarction patients in the United States. When tested, patients were more likely to be treated with higher-potency adenosine diphosphate receptor inhibitors, yet no significant differences in longitudinal outcomes were observed.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26386794</pmid><doi>10.1016/j.ahj.2015.06.021</doi><tpages>9</tpages></addata></record> |
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| subjects | Acute coronary syndromes Aged Blood platelets Blood Platelets - physiology Cardiovascular Clinical medicine Consent Coronary vessels Data collection Electrocardiography Female Follow-Up Studies Heart attacks Hospitalization Humans Male Medical records Middle Aged Myocardial Infarction - blood Myocardial Infarction - diagnosis Myocardial Infarction - therapy Percutaneous Coronary Intervention Pharmacogenetics - methods Platelet Activation - drug effects Platelet Aggregation Inhibitors - therapeutic use Platelet Function Tests Preoperative Period Prospective Studies Studies United States Veins & arteries |
| title | Contemporary use of platelet function and pharmacogenomic testing among patients with acute myocardial infarction undergoing percutaneous coronary intervention in the United States |
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