This week, I am joined by David Holmes, Bill Zoghbi, Ralph Brindis and interventional cardiologists, radiologists, clinical cardiologists, scientists, vascular medicine specialists, surgeons, nurses and others interested in interventional and vascular medicine in San Francisco for CRF’s Transcatheter Cardiovascular Therapeutics Conference—also known as TCT. This year marks the first time ACC is co-sponsoring the symposium and we have been working closely with CRF throughout the year to share content and distribute educational materials. Last year, a “Collaboration Council” of senior physician leaders was formed to set the strategic direction of the partnership in order to accomplish the joint goal of expanding educational opportunities for interventional cardiovascular professionals.

During this year’s conference, over 20 late-breaking clinical trials will be presented, with several that have the potential to significantly impact clinical practice. Results from RAPID GENE, one of the most ground-breaking trials at TCT, were presented this afternoon.  One of the limitations of pharmacogenetic strategies has been the inability to perform rapid genetic testing at the patient’s bedside in the hospital. Currently, costs, a lack of local genetic testing expertise and the inability to provide timely information have been impediments to the application of genetics. As a result, a prospective evaluation of the personalized approach to anti-platelet therapy after PCI based on genetic data has not been possible. This late-breaker evaluated the first point-of-care genetic test in medicine for its accuracy and potential clinical utility by looking at Prasugrel vs. Clopidogrel in CYP2C19*2 carriers.

CYP2C19*2, a common genetic variant, is associated with an increased occurrence of major cardiovascular events following percutaneous coronary intervention (PCI). The innovative point-of-care genetic test, Spartan RX-CYP2C19, used in the study enabled carriers of the genetic variant to be identified within 60 minutes after a buccal swab.

CYP2C19*2 carriers in the rapid genotyping group who were  administered prasugrel saw a significant reduction in the primary endpoint (0%) relative to the standard therapy group (clopidogrel) (30.4%) (p=0.009). The study also found a significant reduction in the percentage of platelet inhibition in carriers from the rapid genotyping group compared to the standard therapy group (73.3% vs. 27.0%, p<0.001).

The authors of the study found that the point-of-care genetic testing device proved feasible in a clinical setting and that it facilitates rapid personalization of anti-platelet therapy. Given these outcomes, we are sure to see larger scale studies that will evaluate the role of pharmacogenomics after PCI in the future.

Keep on the look-out for coverage of other noteworthy trials, including TRIGGER-PCI, BRIDGE, RIFLE STEACS, STACCATO and TWENTE throughout the week.  If you’re in San Francisco for TCT this week, make sure to stop by the ACC’s table in the CRF Collaboration Pavilion on the Lower Level Concourse of Moscone North Hall. I hope to see you there!

For complete coverage:

• Visit the TCT meeting page on CardioSource.org
• Follow ACC on Twitter and Facebook 
• Join the Interventional CardioSource Community
• View the video on RAPID GENE and BRIDGE Trials

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