TABLE 3.
Primary and Secondary Outcomes by CYP2C19 Genotype and by Antiplatelet Therapy
| Outcome | LOF-Clopidogrel (n=226) | LOF-Alternative (n=346) | Non-LOF (n=1243) | Adjusted HR (95% CI) for LOF- Clopidogrel vs LOF- Alternative | Adjusted HR (95% CI) for Non- LOF vs LOF- Alternative | |||
|---|---|---|---|---|---|---|---|---|
| No. (%) | Event rate* | No. (%) | Event rate* | No. (%) | Event rate* | |||
| MACE | 18 (7.96) | 23.4 | 16 (4.62) | 8.7 | 74 (5.95) | 13.7 | 2.26 (1.18–4.32) | 1.14 (0.69–1.88) |
| Death | 8 (3.54) | 10.4 | 6 (1.73) | 3.3 | 36 (2.90) | 6.6 | 3.76 (1.37–10.35) | 1.56 (0.68–3.56) |
| MI | 11 (4.87) | 14.3 | 9 (2.60) | 4.9 | 38 (3.06) | 7.0 | 1.85 (0.77–4.45) | 1.00 (0.52–1.92) |
| Ischemic stroke | 3 (1.33) | 3.9 | 2 (0.58) | 1.1 | 13 (1.05) | 2.4 | 2.81 (0.43–18.03) | 2.52 (0.49–12.91) |
| MACE plus other ischemic events† | 25 (11.06) | 32.5 | 28 (8.09) | 15.2 | 106 (8.53) | 19.6 | 1.82 (1.07–3.12) | 1.09 (0.72–1.63) |
| Stent Thrombosis | 4 (1.77) | 5.2 | 4 (1.16) | 2.2 | 13 (1.05) | 2.4 | 1.68 (0.37–7.53) | 1.01 (0.32–3.15) |
| Unstable angina | 7 (3.10) | 9.1 | 12 (3.47) | 6.5 | 31 (2.49) | 5.7 | 1.41 (0.55–3.64) | 0.87 (0.44–1.70) |
Unadjusted proportion of patients experiencing an event during follow-up (%), event rate (per 100-patient years), adjusted hazard ratio (HR) and 95% confidence interval (CI). The hazard ratio was adjusted with inverse probability weights derived from exposure propensity scores. Refer to Table 2 for variables included in the propensity score.
Event rates were calculated the number of events divided by follow-up time from index PCI to MACE or censoring in patient-years and are presented as medians.
The median length of follow-up was 7.3 (IQR 1.5–10.9), 1.8 (0.2–8.2), and 4.5 (0.5 to 9.7) months in the LOF-alternative, LOF-clopidogrel, and non-LOF groups, respectively (p<0.001).
LOF-Clopidogrel patients were those with at least 1 loss-of-function allele (i.e. (*2, *3…) treated with clopidogrel
LOF-Alternative patients were those with at least 1 loss-of-function allele (i.e. (*2, *3…) treated with prasugrel (n=222), ticagrelor (n=116), or high dose clopidogrel (n=8)
Non-LOF patients were those with no loss-of-function allele: *1/*1, *1/*17, or *17/*17 genotypes.
Median event rate expressed as events per 100 patient-years
Composite of MACE (defined as first occurrence of myocardial infarction, ischemic stroke, or death) plus stent thrombosis and unstable angina